title: Noninvasive assessment of hepatic fibrosis in patients with chronic hepatitis B viral infection using magnetic resonance elastography.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of magnetic resonance elastography (MRE) for staging hepatic fibrosis in patients with chronic hepatitis B virus (HBV) infection.
  
  
  METHODS
  Patients with chronic HBV infection who were suspected of having focal or diffuse liver diseases (n = 195) and living donor candidates (n = 166) underwent MRE as part of the routine liver MRI examination. We measured liver stiffness (LS) values on quantitative shear stiffness maps. The technical success rate of MRE was then determined. Liver cell necroinflammatory activity and fibrosis were assessed using histopathologic examinations as the reference. Areas under the receiver operating characteristic curve (Az) were calculated in order to predict the liver fibrosis stage.
  
  
  RESULTS
  The technical success rate of MRE was 92.5% (334/361). The causes of technical failure were poor wave propagation (n = 12), severe respiratory motion (n = 3), or the presence of iron deposits in the liver (n = 12). The mean LS values, as measured by MRE, increased significantly along with an increase in the fibrosis stage (r = 0.901, p < 0.001); however, the mean LS values did not increase significantly along with the degree of necroinflammatory activity. The cutoff values of LS for ≥ F1, ≥ F2, ≥ F3, and F4 were 2.45 kPa, 2.69 kPa, 3.0 kPa, and 3.94 kPa, respectively, and with Az values of 0.987-0.988.
  
  
  CONCLUSIONS
  MRE has a high technical success rate and excellent diagnostic accuracy for staging hepatic fibrosis in patients with chronic HBV infection.
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Daejeon 301-721, Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. ; Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul 110-744, Korea.
authors.forename: Kyung Bun
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Cheong Il
authors.initials: CI
authors.lastname: Shin
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. ; Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. ; Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D019190:Iron Overload / Q000175:diagnosis; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009068:Movement; D012372:ROC Curve; D012119:Respiration; D055815:Young Adult
keywords: Hepatic fibrosis; Hepatitis B; Liver; Liver cirrhosis; MRE; Magnetic resonance imaging