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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7522-7528
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7522
Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study
Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao
Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Chao M and Li B designed the research; Li B and Min J performed the research and wrote the manuscript; Liang WR, Zhang GQ, and Wu JJ performed the medical imaging reconstruction and data analysis; and Jin K, Huang W, and Ying CY provided technical support.
Supported by Health and Family Planning Commission of Zhejiang Province in China (partly).
Ethics approval: The study was reviewed and approved by the Human Research Ethics Committee of The Second Affiliated Hospital Zhejiang University School of Medicine.
Clinical trial registration: This study is registered at www.chictr.org.cn. The registration identification number is ChiCTR-DCD-15005799.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare that they have no competing interests.
Data sharing: Technical appendix, statistical code, and dataset available from the corresponding author at doctor_chaoming@163.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jie fang Road, Hangzhou 310009, Zhejiang Province, China. doctor_chaoming@163.com
Telephone: +86-571-88767150 Fax: +86-571-87214631
Received: September 26, 2014
Peer-review started: September 29, 2014
First decision: December 2, 2014
Revised: November 14, 2014
Accepted: March 30, 2015
Article in press: March 31, 2015
Published online: June 28, 2015
Processing time: 276 Days and 7.3 Hours
Abstract

AIM: To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve.

METHODS: 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.

RESULTS: 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).

CONCLUSION: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.

Keywords: Magnetic resonance elastography; Liver functional reserve; Indocyanine green clearance test; Liver fibrosis; Hepatocellular carcinoma

Core tip: Liver functional determination is important for the preoperative evaluation of patients with hepatic carcinoma. We used magnetic resonance elastography to measure liver stiffness and then analyzed its correlation with the liver functional reserve test. The results showed that magnetic resonance elastography can be effectively used to assess liver functional reserve.