Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study

• Published in: World journal of gastroenterology : WJG Vol. 21; no. 24; pp. 7522 - 7528
• Main Authors: Li, Bin, Min, Jie, Liang, Wei-Ren, Zhang, Guang-Qiang, Wu, Jian-Jun, Jin, Kai, Huang, Wei, Ying, Cai-Yu, Chao, Ming
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.06.2015
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - metabolism; Carcinoma, Hepatocellular - pathology; Clinical Trials Study; Elasticity Imaging Techniques - methods; Female; Fluorescent Dyes; Humans; Indocyanine Green; Liver - metabolism; Liver - pathology; Liver Function Tests; Liver Neoplasms - diagnosis; Liver Neoplasms - metabolism; Liver Neoplasms - pathology; Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Prognosis; Indocyanine green clearance test; Hepatocellular carcinoma; Magnetic resonance elastography; Liver fibrosis; Liver functional reserve
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v21.i24.7522

To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve. Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma (HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green (ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min (ICGR-15) and the ICG plasma clearance rate (ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K. Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 kPa and 4.7 ± 2.1 kPa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 kPa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15 (r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K (r = -0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K (r = -0.852, P < 0.01). MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.