Abstract
Magnetic resonance (MR) T1 and T2* mapping allows quantification of liver relaxation times for non-invasive characterization of diffuse liver disease. We hypothesized that liver relaxation times are not only influenced by liver fibrosis, inflammation and fat, but also by air in liver segments adjacent to the lung – especially in MR imaging at 3T. A total of 161 study participants were recruited, while 6 patients had to be excluded due to claustrophobia or technically uninterpretable MR elastography. Resulting study population consisted of 12 healthy volunteers and 143 patients who prospectively underwent multiparametric MR imaging at 3T. Of those 143 patients, 79 had normal liver stiffness in MR elastography (shear modulus <2.8 kPa, indicating absence of fibrosis) and normal proton density fat fraction (PDFF < 10%, indicating absence of steatosis), defined as reference population. T1 relaxation times in these patients were significantly shorter in liver segments adjacent to the lung than in those not adjacent to the lung (p < 0.001, mean of differences 33 ms). In liver segments not adjacent to the lung, T1 allowed to differentiate significantly between the reference population and patients with steatosis and/or fibrosis (p ≤ 0.011), while there was no significant difference of T1 between the reference population and healthy volunteers. In conclusion, we propose to measure T1 relaxation times in liver segments not adjacent to the lung. Otherwise, we recommend taking into account slightly shorter T1 values in liver segments adjacent to the lung.
Highlights
Resulting study population consisted of 12 healthy volunteers and 143 patients who prospectively underwent multiparametric Magnetic resonance (MR) imaging at 3T
Existing non-invasive imaging biomarkers for diffuse liver disease include proton density fat fraction (PDFF) calculation[6] and MR elastography[7,8]. Another emerging technique is the quantification of T1 relaxation time on parametric maps, which is routinely used in cardiac imaging[9], for example in diffuse cardiac fibrosis[10,11] or myocarditis[12]
Patients without steatosis but with increased liver stiffness showed a male predominance (78% males vs. 43% males in patients without fibrosis), a higher prevalence of diabetes (35% vs. 3%, p < 0.001), elevated GGT (110 ± 143 vs. 30 ± 33, p < 0.001), and prolonged extrinsic coagulation times (Quick 81 ± 20% vs. 99 ± 3%, p < 0.001)
Summary
Resulting study population consisted of 12 healthy volunteers and 143 patients who prospectively underwent multiparametric MR imaging at 3T Of those 143 patients, 79 had normal liver stiffness in MR elastography (shear modulus
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