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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2018; 24(18): 2024-2035
Published online May 14, 2018. doi: 10.3748/wjg.v24.i18.2024
Quantitative assessment of hepatic fibrosis in chronic hepatitis B and C: T1 mapping on Gd-EOB-DTPA-enhanced liver magnetic resonance imaging
Shen Pan, Xiao-Qi Wang, Qi-Yong Guo
Shen Pan, Qi-Yong Guo, Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Xiao-Qi Wang, Department of Clinical Science, Philips Healthcare, Beijing 100600, China
Author contributions: Pan S and Wang XQ contributed to this work; Pan S and Guo QY designed research; and Pan S wrote the paper.
Supported by National Natural Science Foundation of China, No. 81771893, No. 81771802, No. 81471718 and No. 81401376; and Outstanding Youth Foundation of China Medical University, No. YQ20160005.
Institutional review board statement: This study was reviewed and approved by the Shengjing Hospital of China Medical University Institution Review Board, ID# 2014PS103K.
Informed consent statement: The authors of this paper guarantee that all study participants or their legal guardian(s) provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: There are no conflict of interests in relation to this manuscript.
Data sharing statement: There are no additional data available in relation to this manuscript.
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:
Correspondence to: Qi-Yong Guo, MD, Professor, Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China.
Telephone: +86-13840231345 Fax: +86-96615-73219
Received: March 9, 2018
Peer-review started: March 9, 2018
First decision: March 29, 2018
Revised: April 6, 2018
Accepted: April 15, 2018
Article in press: April 15, 2018
Published online: May 14, 2018

To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for staging liver fibrosis in chronic hepatitis B/C (CHB/C).


We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions (HeF) and relaxation time reduction rate (RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve (AUC) was used to compare the diagnostic performance in predicting liver fibrosis between HeF and RE.


A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23 (31.5%); F1, n = 19 (26.0%); F2, n = 13 (17.8%); F3, n = 6 (8.2%), and F4, n = 12 (16.4%). HeF by EOB enhancement imaging was significantly correlated with fibrosis stage (r = -0.808, P < 0.05). AUC values for diagnosis of any (≥ F1), significant (≥ F2) or advanced (≥ F3) fibrosis, and cirrhosis (F4) using HeF were 0.837 (0.733-0.913), 0.890 (0.795-0.951), 0.957 (0.881-0.990), and 0.957 (0.882-0.991), respectively. HeF measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of HeF is a superior noninvasive liver fibrosis staging method.


A T1 mapping-based HeF method is an efficient diagnostic tool for the staging of liver fibrosis.

Keywords: Liver fibrosis, Gd-EOB-DTPA, Look-Locker, Hepatocyte fraction, Liver function, Magnetic resonance imaging relative enhancement

Core tip: T1 mapping using the Look-Locker method with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging at 3-Tesla by calculating the hepatocyte fraction is an efficient method for the assessment of liver fibrosis in patients with chronic hepatitis B and C, and this method is superior to using reduction rate.