diffuse liver disease
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DIFFUSE LIVER DISEASE. Dr. Bengt Norén M. D, Med Lic. Dep. of Radiology and CMIV University Hospital Linköping. BN 20111207. BN 20111207. BN 20111207. Conventional Biopsy. Inflammation. Fibrosis grading – Biopsy F0- F4 ( Batts and Ludwig ) Grouped into : F0 – F2 F3 – F4. - PowerPoint PPT PresentationTRANSCRIPT
DIFFUSE LIVER DISEASE DIFFUSE LIVER DISEASE
BN 20111207
Dr. Bengt NorénDr. Bengt Norén
M. D, Med Lic.M. D, Med Lic.Dep. of Radiology and CMIVDep. of Radiology and CMIV
University Hospital LinköpingUniversity Hospital Linköping
BN 20111207
BN 20111207
Conventional Biopsy
• Inflammation
• Fibrosis/cirrhosis
• Steatosis
• Fe
BN 20111207
Fibrosis grading – Biopsy
F0- F4 (Batts and Ludwig)
Grouped into :F0 – F2F3 – F4
Non Invasive Liver Biopsy ”NILB”
BN 20111207
1. 31 P MRS
2. DCE-MRI
Fibrosis/cirrhosis ; 31 P MRS
BN 20111207
ConcmM
PME Pi ATPb PDE
Fibrosis/cirrhosis ; 31 P MRS I
Anabolic charge (AC) :[PME] / ([PME] + [PDE])
Patients had a significant larger AC than the control subjects, 0.29 vs 0.16 (p 0.005).
BN 20111207Noren et al European Radiology, 2005, 15(1), 148-157.
BN 20111207
Fibrosis/cirrhosis ; 31 P MRS II
AC
Group BN 20111207
Fibrosis/cirrhosis ; 31 P MRS II
Degree of fibrosis predicted from AC
P = 0.0097. Fisher’s exact test
Fibrosis grade
0-2
Fibrosis grade
3-4
AC 0.27 6 15 21
AC 0.27 7 1 8
13 16 29
AC cut-off value of 0.27 showed a sensitivity of 93% and a specificity of 54 %.
BN 20111207Noren et al European Journal of Radiology, 2008, 66(2), 313-320
Fibrosis/cirrhosis ; 31 P MRS II
Can we identify and separate different stages of fibrosis by quantitatively measure the uptake of Gd-EOB-DTPA (Primovist) using DCE-MRI ?
BN 20111207
Fibrosis/cirrhosis; DCE-MRI
Prospective study.
• 38 patients ( 21 men, 17 women)
• Pathological liver function tests
• Liver biopsy
BN 20111207
Fibrosis/cirrhosis; DCE-MRI
•1.5 T MR (Achieva, Philips Medical Systems )
• T1-weighted 3D GRE (native, arterial and venous portal phase; 3, 10, 20 and 30 min)
BN 20111207
Fibrosis/cirrhosis; DCE-MRI
KHep – contrast uptake rate
LSC_N10 and LSC_N20
LSC10 and LSC20
BN 20111207
F0-2 F3-4 AUROC p-value†
KHep 0.436±0.255a 0.293±0.254c 0,71 0.050*
LSC_N10 1.405±0.120a 1.243±0.138c 0,8 0.004**
LSC_N20 1.555±0.160b 1.382±0.161d 0,78 0.010*
LSC10 1.652±0.196a 1.504±0.252c 0,68 0,09
LSC20 1.823±0.265b 1.663±0.291d 0,64 0,223
Fibrosis/cirrhosis; DCE-MRI
NILB ”Multi parameter Q - MR approach”
• Inflammation
• Fibrosis/cirrhosis
• Steatosis
• Fe
Biopsy MR techniques;
• MRS - 31P• MRS - 1 H• DCE- MRI• MRE• T2/T2*• Diffusion
BN 20111207
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BN 20100906