Quantitative Liver MRI Combining Phase Contrast Imaging, Elastography, and DWI: Assessment of Reproducibility and Postprandial Effect at 3.0 T

• Published in: PloS one Vol. 9; no. 5; p. e97355
• Main Authors: Jajamovich, Guido H., Dyvorne, Hadrien, Donnerhack, Claudia, Taouli, Bachir
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.05.2014; Public Library of Science (PLoS)
• Subjects: Adult; Coefficient of variation; Diffusion; Diffusion coefficient; Diffusion parameters; Diffusion rate; Driving while intoxicated; Elasticity Imaging Techniques - methods; Fasting; Female; Females; Flow; Hepatitis; Humans; Hypertension; Liver; Liver diseases; Liver Diseases - pathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Males; Medicine; Medicine and Health Sciences; Microscopy, Phase-Contrast; Middle Aged; NMR; Nuclear magnetic resonance; Parameters; Patients; Perfusion; Phase contrast; Portal vein; Postprandial Period; Prospective Studies; Reproducibility; Reproducibility of Results; Short term; Stiffness; Ultrasonic imaging; New York; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0097355

To quantify short-term reproducibility (in fasting conditions) and postprandial changes after a meal in portal vein (PV) flow parameters measured with phase contrast (PC) imaging, liver diffusion parameters measured with multiple b value diffusion-weighted imaging (DWI) and liver stiffness (LS) measured with MR elastography (MRE) in healthy volunteers and patients with liver disease at 3.0 T. In this IRB-approved prospective study, 30 subjects (11 healthy volunteers and 19 liver disease patients; 23 males, 7 females; mean age 46.5 y) were enrolled. Imaging included 2D PC imaging, multiple b value DWI and MRE. Subjects were initially scanned twice in fasting state to assess short-term parameter reproducibility, and then scanned 20 min. after a liquid meal. PV flow/velocity, LS, liver true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (PF) and apparent diffusion coefficient (ADC) were measured in fasting and postprandial conditions. Short-term reproducibility was assessed in fasting conditions by measuring coefficients of variation (CV) and Bland-Altman limits of agreement. Differences in MR metrics before and after caloric intake and between healthy volunteers and liver disease patients were assessed. PV flow parameters, D, ADC and LS showed good to excellent short-term reproducibility in fasting state (CV <16%), while PF and D* showed acceptable and poor reproducibility (CV = 20.4% and 51.6%, respectively). PV flow parameters and LS were significantly higher (p<0.04) in postprandial state while liver diffusion parameters showed no significant change (p>0.2). LS was significantly higher in liver disease patients compared to healthy volunteers both in fasting and postprandial conditions (p<0.001). Changes in LS were significantly correlated with changes in PV flow (Spearman rho = 0.48, p = 0.013). Caloric intake had no/minimal/large impact on diffusion/stiffness/portal vein flow, respectively. PC MRI and MRE but not DWI should be performed in controlled fasting state.