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Updated: Aug 9, 2026
A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
Published on: July 21, 2023
Liver fibrosis: noninvasive diagnosis with double contrast material-enhanced MR imaging
Diego A Aguirre1, Cynthia A Behling, Elliot Alpert
1Departments of Radiology, Pathology, and Medicine, University of California, San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103-8756, USA.
Purpose:
To retrospectively evaluate the accuracy of double contrast material-enhanced (hereafter double-enhanced) magnetic resonance (MR) imaging depiction of hepatic fibrosis, with histopathologic analysis findings as the reference standard.
Materials And Methods:
The institutional review board approved this HIPAA-compliant study and waived the requirement for informed consent. One hundred one patients (58 men, 43 women; mean age +/- standard deviation, 52 years +/- 10) who underwent double-enhanced MR imaging with superparamagnetic iron oxide (SPIO)-enhanced and double-enhanced spoiled gradient-echo (SPGR) sequences between 2001 and 2004 and had a reliable reference standard for the diagnosis of liver fibrosis were included. Two blinded MR radiologists retrospectively scored qualitative (reticulation, nodularity, and total scores) and quantitative (contrast-to-noise ratio between hyperintense and hypointense liver regions, coefficient of variation, and noise-corrected coefficient of variation) liver texture features on MR images in consensus. The image scores for patients with advanced (METAVIR fibrosis score >/= 3) versus those for patients with mild (METAVIR score
Results:
Qualitative and quantitative image scores were significantly higher for patients with METAVIR fibrosis scores of 3 or higher than for those with scores of 2 or lower (P < .001); on SPIO-enhanced SPGR images, differences increased with increasing echo time. Diagnostic performance for detection of grade 3 or more severe fibrosis was better with the double-enhanced sequence than with the SPIO-enhanced sequences, and qualitative scores had higher diagnostic performance than quantitative scores. The sensitivity, specificity, and accuracy of qualitative scores on double-enhanced SPGR images were higher than 90%.
Conclusion:
Advanced hepatic fibrosis can be detected by using double-enhanced MR imaging. Although diagnostic performance depended on the sequence and scoring system used, sensitivity, specificity, and accuracy values higher than 90% were achievable.
Insights
Double-enhanced magnetic resonance (MR) imaging accurately detects advanced hepatic fibrosis. This method achieved over 90% sensitivity, specificity, and accuracy in diagnosing liver fibrosis, offering a reliable non-invasive assessment.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Hepatic fibrosis is a significant cause of chronic liver disease.
- Accurate non-invasive staging of liver fibrosis is crucial for patient management.
- Histopathologic analysis remains the gold standard but is invasive.
Purpose of the Study:
- To evaluate the diagnostic accuracy of double contrast material-enhanced magnetic resonance (MR) imaging for hepatic fibrosis.
- To compare the performance of different MR imaging sequences and scoring methods.
Main Methods:
- Retrospective study of 101 patients with histopathologic correlation.
- Utilized double-enhanced MR imaging with superparamagnetic iron oxide (SPIO)-enhanced and spoiled gradient-echo (SPGR) sequences.
- Two radiologists assessed qualitative and quantitative liver texture features.
Main Results:
- Double-enhanced MR imaging showed significantly higher scores in patients with advanced fibrosis (METAVIR score ≥3) compared to mild fibrosis (METAVIR score ≤2).
- The double-enhanced sequence demonstrated superior diagnostic performance over SPIO-enhanced sequences.
- Qualitative scoring on double-enhanced SPGR images achieved >90% sensitivity, specificity, and accuracy.
Conclusions:
- Double-enhanced MR imaging is effective for detecting advanced hepatic fibrosis.
- High diagnostic performance (>90% sensitivity, specificity, accuracy) is achievable with this technique.
- The choice of MR sequence and scoring system influences diagnostic performance.
