title: Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging.
abstract: OBJECTIVE
  To evaluate intrinsic hepatic enhancement patterns on multiphase, gadolinium-enhanced, fat-suppressed, 3D T1-weighted, gradient echo magnetic resonance imaging (MRI) as a quantitative correlate for severity of pathological changes in chronic liver disease (CLD).
  
  
  METHODS
  This study was HIPAA-compliant and Institutional Review Board-approved. In all, 75 patients were studied by contrast-enhanced multiphase abdominal MRI. CLD patients had liver histology correlation derived from right lobe liver biopsies. Contrast-enhanced arterial- and delayed-phase 3D gradient recalled echo (GRE) liver MRI were scored using feature categorization templates to quantify enhancement patterns by three independent readers. Liver histopathology was staged/graded for fibrosis/inflammation using the Scheuer system. Statistical testing for MRI histology correlates used a Pearson's product moment correlation and a Wilcoxon-Mann-Whitney two-sample rank-sum test. Reader agreement was analyzed by a modified Fleiss' kappa test.
  
  
  RESULTS
  MRI histology correlation was high for delayed-phase MRI versus fibrosis stage (95% confidence interval [CI] 0.941 < r < 0.976, P = 5 × 10(-7)), but lower for all other comparisons (delayed-phase vs. inflammation and arterial-phase vs. inflammation or fibrosis all showed a CI no greater than 0.64). Paired testing between delayed-phase MRI score and histology fibrosis staging incremental levels was significant (from P < 10(-2) to P < 10(-5)).
  
  
  CONCLUSIONS
  A standard gadolinium-enhanced liver MRI may provide a correlate measure of hepatic fibrosis over a spectrum of severity.
authors.affiliation: Department of Radiology, University of Arizona School of Medicine, Tucson, AZ, USA. dmartin@radiology.arizona.edu
authors.forename: Diego R
authors.initials: DR
authors.lastname: Martin
authors.forename: Thomas
authors.initials: T
authors.lastname: Lauenstein
authors.forename: Bobby
authors.initials: B
authors.lastname: Kalb
authors.forename: Christina
authors.initials: C
authors.lastname: Lurie
authors.forename: Hiroumi
authors.initials: H
authors.lastname: Kitajima
authors.forename: Puneet
authors.initials: P
authors.lastname: Sharma
authors.forename: Khalil
authors.initials: K
authors.lastname: Salman
authors.forename: Roger
authors.initials: R
authors.lastname: Moreira
authors.forename: Alton B
authors.initials: AB
authors.lastname: Farris
authors.forename: James
authors.initials: J
authors.lastname: Spivey
authors.forename: Enrique
authors.initials: E
authors.lastname: Martinez
authors.forename: Steve
authors.initials: S
authors.lastname: Hanish
authors.forename: Volkan
authors.initials: V
authors.lastname: Adsay
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D017352:Echo-Planar Imaging / Q000379:methods*; D058625:End Stage Liver Disease / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA