title: Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study.
abstract: OBJECTIVE
  To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve.
  
  
  METHODS
  Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma (HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green (ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min (ICGR-15) and the ICG plasma clearance rate (ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K.
  
  
  RESULTS
  Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 kPa and 4.7 ± 2.1 kPa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 kPa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15 (r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K (r = -0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K (r = -0.852, P < 0.01).
  
  
  CONCLUSIONS
  MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Min
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Wei-Ren
authors.initials: WR
authors.lastname: Liang
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Guang-Qiang
authors.initials: GQ
authors.lastname: Zhang
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Wu
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Jin
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Cai-Yu
authors.initials: CY
authors.lastname: Ying
authors.affiliation: Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green
keywords: Hepatocellular carcinoma; Indocyanine green clearance test; Liver fibrosis; Liver functional reserve; Magnetic resonance elastography