Detecting decompensation in cirrhotic patients with varying ascitic volumes using magnetic resonance elastography

This study aims to detect decompensation in cirrhotic patients with varying volumes of ascites using magnetic resonance elastography (MRE).

We prospectively reviewed 70 patients with liver cirrhosis who underwent 3D MRE and gadoxetic acid-enhanced magnetic resonance imaging (MRI). Patients were categorized into three groups based on clinical information and ascitic volume: compensated cirrhosis with no or minimal ascites (Group A, n = 30), decompensated cirrhosis with no or minimal ascites (Group B, n = 21), and decompensated cirrhosis with massive ascites (Group C, n = 19). Laboratory indicators were collected, and the Model for End-Stage Liver Disease (MELD) score was calculated. Liver shear stiffness (LSS) and relative liver enhancement (RLE) were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis assessed the role of LSS in detecting decompensated cirrhosis with no or minimal ascites. Multivariable logistic regression analysis identified factors associated with this condition.

The LSS in Group A (3.68 ± 0.20 kPa) was significantly lower than in Group B (5.95 ± 0.50 kPa) and Group C (6.27 ± 0.68 kPa) (both p < 0.001). The RLE in Group A (74.6%±4.5%) was significantly higher than in Group B (58.2%±5.1%) (p = 0.035) and Group C (43.5%±3.3%) (p < 0.001). ROC analysis indicated that LSS effectively differentiates between Group A and Group B (area under the ROC curve is 0.84, 95% confidence interval [CI]: 0.73-0.95). Multivariable analysis identified LSS as an independent risk factor for decompensated cirrhosis with no or minimal ascites.

MRE is a valuable tool for noninvasively guiding decompensation risk stratification in patients with varying volumes of ascites, particularly those with no or minimal ascites.