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Accuracy of MR elastography and anatomic MR imaging features in the diagnosis of severe hepatic fibrosis and cirrhosis

Authors

  • Rahul Rustogi MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
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  • Jeanne Horowitz MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
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  • Carla Harmath MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
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  • Yi Wang MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
    2. Beijing University People's Hospital, Radiology Department, Beijing, China
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  • Hamid Chalian MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
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  • Daniel R. Ganger MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Medicine, Hepatology Division, Chicago, Illinois, USA
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  • Zongming E. Chen MD,

    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Pathology, Chicago, Illinois, USA
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  • Bradley D. Bolster Jr PhD,

    1. Siemens Healthcare, Rochester, Minnesota, USA
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  • Saurabh Shah PhD,

    1. Siemens Healthcare, Chicago, Illinois, USA
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  • Frank H. Miller MD

    Corresponding author
    1. Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
    • Chief, Body Imaging Section, Medical Director MR Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago IL 60611
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Abstract

Purpose:

To compare the diagnostic accuracy of magnetic resonance imaging elastography (MRE) and anatomic MRI features in the diagnosis of severe hepatic fibrosis and cirrhosis.

Materials and Methods:

Three readers independently assessed presence of morphological changes associated with hepatic fibrosis in 72 patients with liver biopsy including: caudate to right lobe ratios, nodularity, portal venous hypertension (PVH) stigmata, posterior hepatic notch, expanded gallbladder fossa, and right hepatic vein caliber. Three readers measured shear stiffness values using quantitative shear stiffness maps (elastograms). Sensitivity, specificity, and diagnostic accuracy of stiffness values and each morphological feature were calculated. Interreader agreement was summarized using weighted kappa statistics. Intraclass correlation coefficient was used to assess interreader reproducibility of stiffness measurements. Binary logistic regression was used to assess interreader variability for dichotomized stiffness values and each morphological feature.

Results:

Using 5.9 kPa as a cutoff for differentiating F3-F4 from F0-2 stages, overall sensitivity, specificity, and diagnostic accuracy for MRE were 85.4%, 88.4%, and 87%, respectively. Overall interreader agreement for stiffness values was substantial, with an insignificant difference (P = 0.74) in the frequency of differentiating F3-4 from F0-2 fibrosis. Only hepatic nodularity and PVH stigmata showed moderately high overall accuracy of 69.4% and 72.2%. Interreader agreement was substantial only for PVH stigmata, moderate for C/R m, deep notch, and expanded gallbladder fossa. Only posterior hepatic notch (P = 0.82) showed no significant difference in reader rating.

Conclusion:

MRE is a noninvasive, accurate, and reproducible technique compared with conventional features of detecting severe hepatic fibrosis. J. Magn. Reson. Imaging 2012;35:1356–1364. © 2012 Wiley Periodicals, Inc.

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