Magnetic resonance elastography for the noninvasive staging of liver fibrosis.
OBJECTIVE
The purpose of our study was to prospectively compare the success rate and diagnostic accuracy of magnetic resonance elastography, ultrasound elastography, and aspartate aminotransferase to platelets ratio index (APRI) measurements for the noninvasive staging of fibrosis in patients with chronic liver disease.


METHODS
We performed a prospective blind comparison of magnetic resonance elastography, ultrasound elastography, and APRI in a consecutive series of patients who underwent liver biopsy for chronic liver disease in a university-based hospital. Histopathologic staging of liver fibrosis according to the METAVIR scoring system served as the reference.


RESULTS
A total of 141 patients were assessed. The technical success rate of magnetic resonance elastography was higher than that of ultrasound elastography (133/141 [94%] vs 118/141 [84%]; P = .016). Magnetic and ultrasound elastography, APRI measurements, and histopathologic analysis of liver biopsy specimens were technically successful in 96 patients. The areas under the receiver operating characteristic curves of magnetic resonance elasticity (0.994 for F >or= 2; 0.985 for F >or= 3; 0.998 for F = 4) were larger (P < .05) than those of ultrasound elasticity, APRI, and the combination of ultrasound elasticity and APRI (0.837, 0.709, and 0.849 for F >or= 2; 0.906, 0.816, and 0.936 for F >or= 3; 0.930, 0.820, and 0.944 for F = 4, respectively).


CONCLUSIONS
Magnetic resonance elastography has a higher technical success rate than ultrasound elastography and a better diagnostic accuracy than ultrasound elastography and APRI for staging liver fibrosis.
Huwart
Laurent
L
Diagnostic Radiology Unit, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium. huwart.laurent@wanadoo.fr
Sempoux
Christine
C
Vicaut
Eric
E
Salameh
Najat
N
Annet
Laurence
L
Danse
Etienne
E
Peeters
Frank
F
ter Beek
Leon C
LC
Rahier
Jacques
J
Sinkus
Ralph
R
Horsmans
Yves
Y
Van Beers
Bernard E
BE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000592:standards*
D001219:Aspartate Aminotransferases