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Updated: Apr 3, 2026
Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
Chronic Liver Disease: Assessing Inflammation and Fibrosis Using Three-Dimensional MR Elastography With Same-Day
Shan Cai1,2, Christian Simonsson1,2,3, Markus Karlsson1
1Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Background:
Three-dimensional (3D) MR elastography (MRE) derives viscoelastic parameters that may reflect inflammation, but their frequency dependence and the influence of steatosis on inflammation grading and fibrosis staging remain unclear.
Purpose:
To investigate 3D multifrequency MRE for assessing hepatic inflammation, fibrosis stage across frequencies, and the influence of steatosis.
Study Type:
Prospective.
Population:
Sixty-four (40 men, median age: 58 years) participants with chronic liver disease (CLD); 21 (8 men, median age: 28 years) healthy volunteers.
Field Strength/Sequence:
3-T; gradient-echo sequence with mechanical vibrations at low (16.7 and 18 Hz), medium (33.4 and 36 Hz), and high (50.1 and 54 Hz) frequencies.
Assessment:
In CLD participants, MRE-derived viscoelastic parameters, shear stiffness, storage modulus, loss modulus, and damping ratio were compared with histologically assessed fibrosis, inflammation, and steatosis. MRE test-retest repeatability over 10 min was evaluated in healthy volunteers.
Statistical Tests:
Wilcoxon rank sum test, Spearman's correlation, multivariable regression analysis, and area under the receiver operating curve (AUROC). A p value of < 0.05 was considered statistically significant.
Results:
Inflammation was significantly independently associated with damping ratio at medium frequency, which showed moderate performance for grading inflammation (AUROC = 0.76-0.83, sensitivity = 0.83-0.84, specificity = 0.70-0.79). Fibrosis staging using shear stiffness and moduli showed high diagnostic performance (AUROC = 0.82-0.95), with comparable accuracy between medium and high frequencies (p = 0.327-0.896). Steatosis was not significantly correlated with MRE overall (p = 0.212-0.459), but was significantly associated with 19% higher stiffness and 20% higher loss modulus at medium frequency in CLD participants without fibrosis or inflammation.
Data Conclusion:
Medium frequency 3D MRE demonstrated an independent association with inflammation while preserving accurate fibrosis assessment. Steatosis seemed not to confound MRE-based evaluation.
Technical Efficacy:
Stage 2.
