Liver Lobe Based Multi-Echo Gradient Recalled Echo T2*-Weighted Imaging in Chronic Hepatitis B-Related Cirrhosis: Association with the Presence and Child-Pugh Class of Cirrhosis.

Dan Wang,Rui Li,Jie Li,Fan Chen,Li Li,Nan-Lin Zeng,Yu-Lian Tang ,Tianwu Chen ,Xiaoming Zhang ,Yanxiong Huang ,Yanli Chen

doi:10.1371/journal.pone.0154545

Abstract

PurposeTo investigate whether liver lobe based T2* values measured on gradient recalled echo T2*-weighted imaging are associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis.MethodsFifty-six patients with hepatitis B-related cirrhosis and 23 healthy control individuals were enrolled in this study and underwent upper abdominal T2*-weighted magnetic resonance imaging. T2* values of the left lateral lobe (LLL), left medial lobe (LML), right lobe (RL) and caudate lobe (CL) were measured on T2*-weighted imaging. Statistical analyses were performed to determine the association between liver lobe based T2* values and the presence and Child-Pugh class of cirrhosis.ResultsThe T2* values of the LLL, LML and RL decreased with the progression of cirrhosis from Child-Pugh class A to C (r = -0.231, -0.223, and -0.395, respectively; all P < 0.05), except that of the CL (r = -0.181, P > 0.05). To a certain extent, Mann-Whitney U tests with Bonferroni correction for multigroup comparisons showed that the T2* values of the LLL, LML and RL could distinguish cirrhotic liver from healthy liver (all P < 0.05), whereas the T2* values of the CL could not (P > 0.05). Receiver operating characteristic analysis demonstrated that the T2* value of the RL could best distinguish cirrhosis from healthy liver, with an area under the receiver operating characteristic curve (AUC) of 0.713 among T2* values of the liver lobes, and that only the T2* value of the RL could distinguish Child-Pugh class C from A-B, with an AUC of 0.697 (all P < 0.05).ConclusionThe T2* value of the RL can be associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis.

Highlights

Liver cirrhosis is a frequent consequence of chronic liver diseases, such as Hepatitis B, and is characterized by tissue fibrosis and the conversion of healthy liver architecture into structurally abnormal nodules [1]
The T2* values of the lateral lobe (LLL), left medial lobe (LML) and right lobe (RL) decreased with the progression of cirrhosis from Child-Pugh class A to C (r = -0.231, -0.223, and -0.395, respectively; all P < 0.05), except that of the caudate lobe (CL) (r = -0.181, P > 0.05)
Mann-Whitney U tests with Bonferroni correction for multigroup comparisons showed that the T2* values of the LLL, LML and RL could distinguish cirrhotic liver from healthy liver, whereas the T2* values of the CL could not (P > 0.05)

Summary

Introduction

Liver cirrhosis is a frequent consequence of chronic liver diseases, such as Hepatitis B, and is characterized by tissue fibrosis and the conversion of healthy liver architecture into structurally abnormal nodules [1]. Following noninvasive procedures to assess liver function, the Child-Pugh classification system divides patients with cirrhosis into low (class A), intermediate (class B), and poor (class C) risk categories to differentiate between the least sick and the most advanced patients [5]. Liver iron deposition increases, and hemodynamic disorder occurs in advanced cirrhosis [6, 7]. According to Chung et al [11], the T2Ã value of a cirrhotic liver is lower than that of a healthy liver and decreases as the Child-Pugh class progresses from A to C, due to increasing liver iron concentrations. As reported by Jin et al [12], when deoxyhemoglobin increases in cirrhotic livers, the T2Ã value is lower than that of healthy livers and decreases with the severity of liver fibrosis. The previous findings were based on the T2Ã value of the whole liver

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