Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

T2 Values for Diagnosing Acute-on-Chronic Liver Failure in Hepatitis B Patients

Author(s): Lianjun Lan, Xiaofei Lu and Jian Shu*

Volume 17, Issue 1, 2021

Published on: 25 June, 2020

Page: [129 - 135] Pages: 7

DOI: 10.2174/1573405616666200625152357

Price: $65

Abstract

Objectives: The aim of this study was to investigate the value of hepatic T2 imaging for the evaluation of chronic hepatitis-B-related acute-on-chronic liver failure (HBV-ACLF).

Methods: Three groups of patients underwent liver MRI utilising m-GRASE sequence (multi-echo gradient and spin echo): HBV-ACLF patients (n = 28), chronic hepatitis B patients (n = 11), and healthy control patients (n = 14). A T2 image was produced using post-processing software, and the mean T2 (relaxation time) value was calculated. Blood biochemical indices for the HBV-ACLF and Chronic Hepatitis B were obtained within 2 days pre- or post-MR scanning. The patients’ T2 values, and the correlation between their biochemical indices and T2 values were analysed. A receiver operating characteristic curve was employed to evaluate the efficiency of utilising T2 values in the diagnosis of HBV-ACLF.

Results: There were significant variations in the T2 values (χ2 = 19.074, P < 0.001) among the 3 groups. The AUC of T2 values for diagnosing HBV-ACLF was 0.86 (P < 0.001), with a cut-off value of 57.73 ms. A moderately positive correlation was observed between the T2 value and the international normalised ratio, prothrombin time, and hyaluronic acid values (rs = 0.65, P < 0.001; rs = 0.67, P < 0.001; rs = 0.39, P = 0.025). A moderately negative correlation was observed between the T2 value and the prothrombin activity, albumin, and prealbumin values (rs = -0.67, P < 0.001; rs = -0.48, P = 0.004; rs = -0.37, P = 0.030).

Conclusion: T2 values could accurately reflect liver function state, as they correlated well with certain biochemical indices, illustrating good diagnostic efficiency for diagnosing HBV-ACLF.

Keywords: Liver failure, magnetic resonance imaging, T2 relaxation time, HBV-ACLF, hepatic T2 imaging, hepatic inflammation.

Graphical Abstract

[1]
Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 2012; 30(12): 2212-9.
[http://dx.doi.org/10.1016/j.vaccine.2011.12.116] [PMID: 22273662]
[2]
Liver failure and artificial liver group of the infectious diseases branch of the Chinese Medical Association, The liver disease and artificial liver group of the Chinese Medical Association for Hepatology. Guidelines for the diagnosis and treatment of liver failure (2012 Verson). J Clin Hepatol 2013; 16(3): 210-6.
[3]
Shi Y, Yang Y, Hu Y, et al. Acute-on-chronic liver failure precipitated by hepatic injury is distinct from that precipitated by extrahepatic insults. Hepatology 2015; 62(1): 232-42.
[http://dx.doi.org/10.1002/hep.27795] [PMID: 25800029]
[4]
Xie GJ, Zhang HY, Chen Q, et al. Changing etiologies and outcome of liver failure in Southwest China. Virol J 2016; 13(1): 89.
[http://dx.doi.org/10.1186/s12985-016-0536-0] [PMID: 27260248]
[5]
Carey E, Carey WD. Noninvasive tests for liver disease, fibrosis, and cirrhosis: Is liver biopsy obsolete? Cleve Clin J Med 2010; 77(8): 519-27.
[http://dx.doi.org/10.3949/ccjm.77a.09138] [PMID: 20682514]
[6]
Kocakoc E, Bakan AA, Poyrazoglu OK, et al. Assessment of liver fibrosis with diffusion-weighted magnetic resonance imaging using different b-values in chronic viral hepatitis. Med Princ Pract 2015; 24(6): 522-6.
[http://dx.doi.org/10.1159/000434682] [PMID: 26183515]
[7]
Li SL, Zhang XL, Zhu YF, et al. Experimental study of correlation between T1-value, T2-value and ADC-value in MRI with pathological scores grading and fibrosis stagin. J Med Imaging (Bellingham) 2009; 19(1): 56-60.
[8]
Chinese Society of Infectious Diseases and Parasitology and Chinese Society of Hepatology of Chinese Medical Association. The programme of prevention and cure for viral hepatitis. Chin J Hepatol 2000; 8: 324-9.
[9]
Talwalkar JA, Yin M, Fidler JL, Sanderson SO, Kamath PS, Ehman RL. Magnetic resonance imaging of hepatic fibrosis: emerging clinical applications. Hepatology 2008; 47(1): 332-42.
[http://dx.doi.org/10.1002/hep.21972] [PMID: 18161879]
[10]
Manning DS, Afdhal NH. Diagnosis and quantitation of fibrosis. Gastroenterology 2008; 134(6): 1670-81.
[http://dx.doi.org/10.1053/j.gastro.2008.03.001] [PMID: 18471546]
[11]
Lüsse S, Claassen H, Gehrke T, et al. Evaluation of water content by spatially resolved transverse relaxation times of human articular cartilage. Magn Reson Imaging 2000; 18(4): 423-30.
[http://dx.doi.org/10.1016/S0730-725X(99)00144-7] [PMID: 10788720]
[12]
Chen L, Queenie C, Liang W, et al. Quantitiative evaluation of early kenn osteoarthritis using T1ρ and T2 mapping. Chin J Med Imaging 2014; 30(5): 776-9.
[13]
Crema MD, Roemer FW, Marra MD, et al. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics 2011; 31(1): 37-61.
[http://dx.doi.org/10.1148/rg.311105084] [PMID: 21257932]
[14]
Song R, Lin W, Chen Q, Asakura T, Wehrli FW, Song HK. Relationships between MR transverse relaxation parameters R*(2), R(2) and R′(2) and hepatic iron content in thalassemic mice at 1.5 T and 3 T. NMR Biomed 2008; 21(6): 574-80.
[http://dx.doi.org/10.1002/nbm.1227] [PMID: 18041805]
[15]
Wood JC, Enriquez C, Ghugre N, et al. MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 2005; 106(4): 1460-5.
[http://dx.doi.org/10.1182/blood-2004-10-3982] [PMID: 15860670]
[16]
Voskaridou E, Douskou M, Terpos E, et al. Magnetic resonance imaging in the evaluation of iron overload in patients with beta thalassaemia and sickle cell disease. Br J Haematol 2004; 126(5): 736-42.
[http://dx.doi.org/10.1111/j.1365-2141.2004.05104.x] [PMID: 15327528]
[17]
Karimi M, Amirmoezi F, Haghpanah S, et al. Correlation of serum ferritin levels with hepatic MRI T2 and liver iron concentration in nontransfusion beta-thalassemia intermediate patients: A contemporary issue. Pediatr Hematol Oncol 2017; 34(5): 292-7.
[http://dx.doi.org/10.1080/08880018.2017.1400135] [PMID: 29190176]
[18]
St Pierre TG, Clark PR, Chua-anusorn W, et al. Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 2005; 105(2): 855-61.
[http://dx.doi.org/10.1182/blood-2004-01-0177] [PMID: 15256427]
[19]
Heye T, Yang SR, Bock M, et al. MR relaxometry of the liver: significant elevation of T1 relaxation time in patients with liver cirrhosis. Eur Radiol 2012; 22(6): 1224-32.
[http://dx.doi.org/10.1007/s00330-012-2378-5] [PMID: 22302503]
[20]
Chow AM, Gao DS, Fan SJ, et al. Measurement of liver T2 and T2 relaxation times in an experimental mouse model of liver fibrosis. J Magn Reson Imaging 2012; 36(1): 152-8.
[http://dx.doi.org/10.1002/jmri.23606] [PMID: 22334510]
[21]
Aubé C, Moal F, Oberti F, et al. Diagnosis and measurement of liver fibrosis by MRI in bile duct ligated rats. Dig Dis Sci 2007; 52(10): 2601-9.
[http://dx.doi.org/10.1007/s10620-006-9143-z] [PMID: 17429735]
[22]
Guimaraes AR, Siqueira L, Uppal R, et al. T2 relaxation time is related to liver fibrosis severity. Quant Imaging Med Surg 2016; 6(2): 103-14.
[http://dx.doi.org/10.21037/qims.2016.03.02] [PMID: 27190762]
[23]
Cassinotto C, Feldis M, Vergniol J, et al. MR relaxometry in chronic liver diseases: Comparison of T1 mapping, T2 mapping, and diffusion-weighted imaging for assessing cirrhosis diagnosis and severity. Eur J Radiol 2015; 84(8): 1459-65.
[http://dx.doi.org/10.1016/j.ejrad.2015.05.019] [PMID: 26032126]
[24]
Zhang H, Yang Q, Yu T, et al. Comparison of T2, T1rho, and diffusion metrics in assessment of liver fibrosis in rats. J Magn Reson Imaging 2017; 45(3): 741-50.
[http://dx.doi.org/10.1002/jmri.25424] [PMID: 27527587]
[25]
Anderson SW, Jara H, Ozonoff A, O’Brien M, Hamilton JA, Soto JA. Effect of disease progression on liver apparent diffusion coefficient and T2 values in a murine model of hepatic fibrosis at 11.7 Tesla MRI. J Magn Reson Imaging 2012; 35(1): 140-6.
[http://dx.doi.org/10.1002/jmri.22807] [PMID: 21990020]
[26]
Kritsaneepaiboon S, Ina N, Chotsampancharoen T, Roymanee S, Cheewatanakornkul S. The relationship between myocardial and hepatic T2 and T2* at 1.5T and 3T MRI in normal and iron-overloaded patients. Acta Radiol 2018; 59(3): 355-62.
[http://dx.doi.org/10.1177/0284185117715285] [PMID: 28592152]

Rights & Permissions Print Cite
Article Metrics
14
© 2024 Bentham Science Publishers | Privacy Policy