title: Spleen dynamic contrast-enhanced magnetic resonance imaging as a new method for staging liver fibrosis in a piglet model.
abstract: OBJECTIVE
  To explore spleen hemodynamic alteration in liver fibrosis with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and to determine how to stage liver fibrosis with spleen DCE-MRI parameters.
  
  
  METHODS
  Sixteen piglets were prospectively used to model liver fibrosis staged by liver biopsy, and underwent spleen DCE-MRI on 0, 5th, 9th, 16th and 21st weekend after modeling this disease. DCE-MRI parameters including time to peak (TTP), positive enhancement integral (PEI), maximum slope of increase (MSI) and maximum slope of decrease (MSD) of spleen were measured, and statistically analyzed to stage this disease.
  
  
  RESULTS
  Spearman's rank correlation tests showed that TTP tended to increase with increasing stages of liver fibrosis (r = 0.647, P<0.001), and that PEI tended to decrease from stage 0 to 4 (r = -0.709, P<0.001). MSD increased slightly from stage 0 to 2 (P>0.05), and decreased from stage 2 to 4 (P<0.05). MSI increased from stage 0 to 1, and decreased from stage 1 to 4 (all P>0.05). Mann-Whitney tests demonstrated that TTP and PEI could classify fibrosis between stage 0 and 1-4, between 0-1 and 2-4, between 0-2 and 3-4, or between 0-3 and 4 (all P<0.01). MSD could discriminate between 0-2 and 3-4 (P = 0.006), or between 0-3 and 4 (P = 0.012). MSI could not differentiate between any two stages. Receiver operating characteristic analysis illustrated that area under receiver operating characteristic curve (AUC) of TTP was larger than of PEI for classifying stage ≥1 and ≥2 (AUC = 0.851 and 0.783, respectively). PEI could best classify stage ≥3 and 4 (AUC = 0.903 and 0.96, respectively).
  
  
  CONCLUSIONS
  Spleen DCE-MRI has potential to monitor spleen hemodynamic alteration and classify liver fibrosis stages.
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Tian-wu
authors.initials: TW
authors.lastname: Chen
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Zhang
authors.affiliation: Department of Anatomy, and Morphometric Research Laboratory, North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Cheng-jun
authors.initials: CJ
authors.lastname: Li
authors.affiliation: Department of Radiology, Third Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan, China.
authors.forename: Zhen-feng
authors.initials: ZF
authors.lastname: Yang
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Nan-lin
authors.initials: NL
authors.lastname: Zeng
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Li-ying
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Li
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Chun-ping
authors.initials: CP
authors.lastname: Li
authors.affiliation: Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Xian-yong
authors.initials: XY
authors.lastname: Xie
mesh_terms: D000818:Animals; D003287:Contrast Media; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015588:Observer Variation; D012372:ROC Curve; D013154:Spleen / Q000503:physiopathology*; D013552:Swine
chemical_list: D003287:Contrast Media