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Non‐invasive assessment of liver fibrosis using magnetic resonance elastography in liver transplant recipients with hepatitis C
Author(s) -
Crespo Sergio,
Bridges Mellena,
Nakhleh Raouf,
McPhail Andre,
Pungpapong Surakit,
Keaveny Andrew P.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12180
Subject(s) - magnetic resonance elastography , medicine , elastography , fibrosis , liver biopsy , receiver operating characteristic , magnetic resonance imaging , biopsy , liver transplantation , transient elastography , hepatitis c , gastroenterology , radiology , pathology , transplantation , ultrasound
Background Liver biopsy has been the reference standard when evaluating fibrosis due to recurrent hepatitis after liver transplantation. Magnetic resonance elastography estimates liver stiffness, correlating to fibrosis. Aim To investigate the utility of elastography in staging liver fibrosis in transplant recipients with hepatitis C. Methods Fifty‐four patients, ≥12 months post‐transplant, underwent elastography within three months of biopsy. Discriminatory capability for METAVIR fibrosis stages F0–2 vs. F3–4 and receiver operating characteristic curve (ROC) analysis were determined. Results On biopsy, 27 patients had METAVIR fibrosis score 0–1; 12 had a 3 or 4. There was significant correlation between histologic fibrosis and shear stiffness ( R ² = 0.588, p < 0.0001). Using a cutoff value of 3.5 kP a, elastography was 91% sensitive and 72% specific in differentiating fibrosis scores of ≥3 from 0 to 1. The AUC of elastography in predicting a fibrosis score of ≥3 was 0.92. Multivariate analysis revealed no correlation between the grade of histologic inflammation and liver stiffness measured by magnetic resonance elastography ( R ² = 0.265, p = 0.47). Conclusion Magnetic resonance elastography is an accurate non‐invasive technique for excluding stage ≥3 graft in recipients with hepatitis C.