Elsevier

Journal of Hepatology

Volume 64, Issue 2, February 2016, Pages 308-315
Journal of Hepatology

Research Article
Multiparametric magnetic resonance imaging predicts clinical outcomes in patients with chronic liver disease

https://doi.org/10.1016/j.jhep.2015.10.009Get rights and content
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open access

Background & Aims

Multiparametric magnetic resonance (MR) imaging has been demonstrated to quantify hepatic fibrosis, iron, and steatosis. The aim of this study was to determine if MR can be used to predict negative clinical outcomes in liver disease patients.

Methods

Patients with chronic liver disease (n = 112) were recruited for MR imaging and data on the development of liver related clinical events were collected by medical records review. The median follow-up was 27 months. MR data were analysed blinded for the Liver Inflammation and Fibrosis score (LIF; <1, 1–1.99, 2–2.99, and ⩾3 representing normal, mild, moderate, and severe liver disease, respectively), T2∗ for liver iron content and proportion of liver fat. Baseline liver biopsy was performed in 102 patients.

Results

Liver disease aetiologies included non-alcoholic fatty liver disease (35%) and chronic viral hepatitis (30%). Histologically, fibrosis was mild in 54 (48%), moderate in 17 (15%), and severe in 31 (28%) patients. Overall mortality was 5%. Ten patients (11%) developed at least one liver related clinical event. The negative predictive value of LIF <2 was 100%. Two patients with LIF 2–2.99 and eight with LIF ⩾3 had a clinical event. Patients with LIF ⩾3 had a higher cumulative risk for developing clinical events, compared to those with LIF <1 (p = 0.02) and LIF 1–1.99 (p = 0.03). Cox regression analysis including all 3 variables (fat, iron, LIF) resulted in an enhanced LIF predictive value.

Conclusions

Non-invasive standardised multiparametric MR technology may be used to predict clinical outcomes in patients with chronic liver disease.

Abbreviations

MR
magnetic resonance
LIF
Liver Inflammation and Fibrosis score
NAFLD
non-alcoholic fatty liver disease
NASH
non-alcoholic steatohepatitis
ELF
Extended Liver Fibrosis
MRE
magnetic resonance elastography
1H-MRS
proton magnetic resonance spectroscopy
HCC
hepatocellular carcinoma
cT1
iron corrected T1
LMS
LiverMultiScan

Keywords

T1 mapping
Iron corrected T1
LIF score
LiverMultiScan

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