Magnetic Resonance Elastography Versus Shear Wave Elastography in Chronic Liver Disease

Chronic liver diseases (CLDs) present significant global health challenges due to their potential progression to severe conditions, including hepatic fibrosis and hepatocellular carcinoma Accurate and timely assessment of liver fibrosis is crucial for managing these diseases effectively. Liver biopsy has limitations prompting interest in non-invasive alternatives like elastography. This study aimed to compare the diagnostic accuracy of magnetic resonance elastography (MRE) and point shear wave elastography (SWE) (ElastPQ) in assessing liver fibrosis in patients with CLDs.

We conducted a prospective observational study involving 40 patients diagnosed with CLD. The patients were categorized into four distinct groups: chronic hepatitis B, chronic hepatitis C, metabolic dysfunction-associated steatotic liver disease, and autoimmune hepatitis. Participants underwent liver biopsy, and liver stiffness was measured using MRE and SWE (ElastPQ), with stiffness quantified in kilopascals. Biopsy samples were evaluated histopathologically using the METAVIR scoring system. Statistical analyses compared means and assessed diagnostic accuracy and correlations between variables.

MRE exhibited superior diagnostic accuracy for any fibrosis (area under the receiver operating characteristic curve [AUROC]: 0.966), significant fibrosis (AUROC: 0.928), and severe fibrosis (AUROC: 0.902) compared to ElastPQ, which had AUROCs of 0.768, 0.737, and 0.809, respectively. There was a significant positive correlation observed between MRE measurements and fibrosis stage (ρ = 0.844, P < 0.001). MRE was particularly effective in patients with chronic viral hepatitis without chronic kidney disease (AUROC: 1.000) and outperformed ElastPQ in detecting significant fibrosis.

MRE is more sensitive than ultrasound elastography in detecting significant liver fibrosis, which is crucial for guiding timely intervention.