title: MR relaxometry in chronic liver diseases: Comparison of T1 mapping, T2 mapping, and diffusion-weighted imaging for assessing cirrhosis diagnosis and severity.
abstract: BACKGROUND
  MR relaxometry has been extensively studied in the field of cardiac diseases, but its contribution to liver imaging is unclear. We aimed to compare liver and spleen T1 mapping, T2 mapping, and diffusion-weighted MR imaging (DWI) for assessing the diagnosis and severity of cirrhosis.
  
  
  METHODS
  We prospectively included 129 patients with normal (n=40) and cirrhotic livers (n=89) from May to September 2014. Non-enhanced liver T1 mapping, splenic T2 mapping, and liver and splenic DWI were measured and compared for assessing cirrhosis severity using Child-Pugh score, MELD score, and presence or not of large esophageal varices (EVs) and liver stiffness measurements using Fibroscan(®) as reference.
  
  
  RESULTS
  Liver T1 mapping was the only variable demonstrating significant differences between normal patients (500±79ms), Child-Pugh A patients (574±84ms) and Child-Pugh B/C patients (690±147ms; all p-values <0.00001). Liver T1 mapping had a significant correlation with Child-Pugh score (Pearson's correlation coefficient of 0.46), MEDL score (0.30), and liver stiffness measurement (0.52). Areas under the receiver operating characteristic curves of liver T1 mapping for the diagnosis of cirrhosis (O.85; 95% confidence intervals (CI), 0.77-0.91), Child-Pugh B/C cirrhosis (0.87; 95%CI, 0.76-0.93), and large EVs (0.75; 95%CI, 0.63-0.83) were greater than that of spleen T2 mapping, liver and spleen DWI (all p-values<0.01).
  
  
  CONCLUSIONS
  Liver T1 mapping is a promising new diagnostic tool for assessing cirrhosis diagnosis and severity, showing higher diagnostic accuracy than liver and spleen DWI, while T2 mapping is not reliable.
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France; INSERM U1053, Université Bordeaux, Bordeaux, France. Electronic address: christophe.cassinotto@chu-bordeaux.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cassinotto
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: matthieu.feldis@chu-bordeaux.fr.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Feldis
authors.affiliation: Centre D'investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: julien.vergniol@chu-bordeaux.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: amaury.mouries@chu-bordeaux.fr.
authors.forename: Amaury
authors.initials: A
authors.lastname: Mouries
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: hubert.cochet@chu-bordeaux.fr.
authors.forename: Hubert
authors.initials: H
authors.lastname: Cochet
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: bruno.lapuyade@chu-bordeaux.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lapuyade
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: arnaud.hocquelet@chu-bordeaux.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Hocquelet
authors.affiliation: Centre D'investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: etienne.juanola@chu-bordeaux.fr.
authors.forename: Etienne
authors.initials: E
authors.lastname: Juanola
authors.affiliation: Centre D'investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: juliette.foucher@chu-bordeaux.fr.
authors.forename: Juliette
authors.initials: J
authors.lastname: Foucher
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire et Université de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France; INSERM U1053, Université Bordeaux, Bordeaux, France; Centre D'investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: francois.laurent@chu-bordeaux.fr.
authors.forename: François
authors.initials: F
authors.lastname: Laurent
authors.affiliation: INSERM U1053, Université Bordeaux, Bordeaux, France; Centre D'investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France. Electronic address: victor.deledinghen@chu-bordeaux.fr.
authors.forename: Victor
authors.initials: V
authors.lastname: De Ledinghen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Cirrhosis; Diffusion-weighted imaging; Liver diseases; MR relaxometry; Magnetic resonance imaging; T1 mapping