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3D‐liver perfusion MRI with the MS‐325 blood pool agent: A noninvasive protocol to asses liver fibrosis
Author(s) -
Leporq Benjamin,
Dumortier Jérôme,
Pilleul Frank,
Beuf Olivier
Publication year - 2012
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.23594
Subject(s) - perfusion , medicine , cirrhosis , magnetic resonance imaging , fibrosis , perfusion scanning , stage (stratigraphy) , radiology , biopsy , nuclear medicine , paleontology , biology
Purpose: To evaluate a 1.5T magnetic resonance imaging (MRI) protocol, including a dedicated acquisition sequence and a postprocessing tool for the quantitative analysis of hepatic tissue perfusion. Estimated perfusion parameters and histological results based on the METAVIR classification were prospectively compared for hepatic fibrosis assessment. Materials and Methods: The study protocol was approved by the experimentation Ethics Committee and informed consent was obtained. Sixteen patients (6 women, 10 men; average age, 52.4 ± 14.8 years) with chronic liver diseases were prospectively enrolled after a liver biopsy. MS‐325 (paramagnetic blood pool agent)‐enhanced MRI was performed using a free‐breath 3D‐VIBE T 1w sequence. Image volumes were registered by an automatic rigid method. Liver perfusion was modeled by a dual‐input‐one‐compartment model and quantitative perfusion parameters such as arterial, portal, and total perfusion mean transit time (MTT) and hepatic perfusion index (HPI) were obtained using in‐house developed software. Results: Arterial perfusion increased with METAVIR stage, whereas portal perfusion decreased leading to an HPI increase with fibrosis stage. MTT increased with F3, F4. A nonparametric Mann–Whitney test demonstrated that HPI and portal perfusion were relevant in discriminating between advanced and nonadvanced fibrosis, between fibrosis and cirrhosis, then between nonfibrosis and fibrosis ( P < 0.01). A strong correlation was found between portal perfusion fall‐off and HPI increase ( r = −0.97; P < 0.001). HPI and portal perfusion were strongly correlated with fibrosis stage ( r = 0.83 and −0.88; P < 0.001, respectively). Conclusion: HPI and portal perfusion could be relevant indicators for the clinical follow‐up in patients with chronic liver diseases. J. Magn. Reson. Imaging 2012;35:1380–1387. © 2012 Wiley Periodicals, Inc.