Abstract
Magnetic resonance elastography (MRE) is a reliable noninvasive method for assessment of hepatic stiffness. Liver stiffness is known to be affected by elevated postprandial portal blood flow in patients with chronic liver disease. The goal of this study was to determine whether food intake affects liver stiffness in the absence of known liver disease. We evaluated 100 volunteers (35 men and 65 women) who met inclusion criteria. The subjects had two MRE examinations, first while fasting and then 30 min after a test meal. Fourteen subjects also had two additional MRE exams 1 h 30 min and 2 h 30 min after the meal. Liver stiffness was measured by placing the largest possible polygon ROIs on the four widest liver slices and calculated as a mean of stiffness values from each slice. The correlation of liver stiffness values before and after the meal was assessed using a paired t-test. To evaluate the relationship between the change in postprandial liver stiffness and fasting liver stiffness values, linear regression was performed. The liver stiffness values in the fasting state ranged from 1.84 to 2.82 kPa, with a mean of 2.30 ± 0.23 kPa (95% CI 2.25–2.34). At 30 min after the meal, liver stiffness values ranged from 2.12 to 3.50 kPa, with a mean of 2.70 ± 0.28 kPa (95% CI 2.64–2.75), demonstrating a systematic postprandial increase by 0.40 ± 0.23 kPa (17.7 ± 3.5%). Meal intake significantly increases liver stiffness in healthy individuals, which persists for at least 2 h 30 min. Patients should fast for 3–4 h before MRE examinations to avoid fibrosis overstaging due to postprandial liver stiffness augmentation.
Highlights
Magnetic resonance elastography (MRE) is a reliable noninvasive method for assessment of hepatic stiffness
It has been recommended that patients should fast for at least 4 h before MRE exams, in order to avoid transient postprandial liver stiffness augmentation that is known to occur in some p atients[16]
While the mean difference of 17.7% is within the range of test–retest variability (19%) documented in the QIBA consensus profile for M RE16, the observed effect could result in incorrect staging of liver fibrosis even in patients without a history of chronic liver disease
Summary
Magnetic resonance elastography (MRE) is a reliable noninvasive method for assessment of hepatic stiffness. Mean stiffness values are obtained from regions-of-interest (ROI) in the liver and used for interpretation Patient variables such as age, sex, obesity, and hepatic steatosis have been shown to have little or no effect on MRE-based measurements of liver s tiffness[6]. It has been recommended that patients should fast for at least 4 h before MRE exams, in order to avoid transient postprandial liver stiffness augmentation that is known to occur in some p atients[16]. This effect has been best documented in patients with chronic liver disease and could result in overstaging fibrosis[11,17,18]. Less evidence is available about the magnitude of this effect in patients without a history of chronic liver disease
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