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Updated: May 25, 2026
A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
Published on: July 21, 2023
3D-liver perfusion MRI with the MS-325 blood pool agent: a noninvasive protocol to asses liver fibrosis
Benjamin Leporq1, Jérôme Dumortier, Frank Pilleul
1Université de Lyon, CREATIS, CNRS UMR 5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Villeurbanne, France.
Purpose:
To evaluate a 1.5T magnetic resonance imaging (MRI) protocol, including a dedicated acquisition sequence and a postprocessing tool for the quantitative analysis of hepatic tissue perfusion. Estimated perfusion parameters and histological results based on the METAVIR classification were prospectively compared for hepatic fibrosis assessment.
Materials And Methods:
The study protocol was approved by the experimentation Ethics Committee and informed consent was obtained. Sixteen patients (6 women, 10 men; average age, 52.4 ± 14.8 years) with chronic liver diseases were prospectively enrolled after a liver biopsy. MS-325 (paramagnetic blood pool agent)-enhanced MRI was performed using a free-breath 3D-VIBE T(1w) sequence. Image volumes were registered by an automatic rigid method. Liver perfusion was modeled by a dual-input-one-compartment model and quantitative perfusion parameters such as arterial, portal, and total perfusion mean transit time (MTT) and hepatic perfusion index (HPI) were obtained using in-house developed software.
Results:
Arterial perfusion increased with METAVIR stage, whereas portal perfusion decreased leading to an HPI increase with fibrosis stage. MTT increased with F3, F4. A nonparametric Mann-Whitney test demonstrated that HPI and portal perfusion were relevant in discriminating between advanced and nonadvanced fibrosis, between fibrosis and cirrhosis, then between nonfibrosis and fibrosis (P < 0.01). A strong correlation was found between portal perfusion fall-off and HPI increase (r = -0.97; P < 0.001). HPI and portal perfusion were strongly correlated with fibrosis stage (r = 0.83 and -0.88; P < 0.001, respectively).
Conclusion:
HPI and portal perfusion could be relevant indicators for the clinical follow-up in patients with chronic liver diseases.
Insights
This study shows that hepatic perfusion index (HPI) and portal perfusion measured by MRI can effectively assess liver fibrosis. These quantitative MRI parameters show strong correlation with fibrosis stage, aiding in clinical follow-up for chronic liver diseases.
Area of Science:
- Medical Imaging
- Hepatology
- Quantitative MRI
Background:
- Chronic liver diseases require accurate assessment of hepatic fibrosis.
- Histological analysis via liver biopsy is invasive and has limitations.
- Non-invasive imaging techniques are needed for fibrosis staging.
Purpose of the Study:
- To evaluate a 1.5T MRI protocol for quantitative analysis of hepatic tissue perfusion.
- To assess hepatic fibrosis using estimated perfusion parameters compared to histological results.
- To validate a new MRI sequence and postprocessing tool for liver perfusion analysis.
Main Methods:
- Prospective enrollment of 16 patients with chronic liver diseases post-biopsy.
- MS-325 enhanced 3D-VIBE T(1w) MRI sequence performed.
- Dual-input-one-compartment model used for quantitative perfusion parameters (MTT, HPI).
Main Results:
- Hepatic perfusion index (HPI) and portal perfusion correlated significantly with fibrosis stage (r=0.83 and r=-0.88, P<0.001).
- Arterial perfusion increased, while portal perfusion decreased with advancing fibrosis.
- HPI and portal perfusion effectively discriminated between different stages of liver fibrosis and cirrhosis.
Conclusions:
- Quantitative MRI parameters, specifically HPI and portal perfusion, are reliable indicators for liver fibrosis.
- These non-invasive MRI findings can aid in the clinical follow-up of patients with chronic liver diseases.
- The developed MRI protocol offers a promising tool for non-invasive hepatic fibrosis assessment.
