Dynamic Postprandial Hepatic Stiffness Augmentation Assessed With MR Elastography in Patients With Chronic Liver Disease

作者：Meng Yin, Jayant A. Talwalkar, Kevin J. Glaser, Sudhakar Kundapur Venkatesh, Jun Chen, Armando Manduca, Richard L. Ehman · 发表于：American Journal of Roentgenology · 年份：2011 · DOI：10.2214/ajr.10.5989 · 被引用次数：127 · 研究领域：Liver Disease Diagnosis and Treatment、Ultrasound Imaging and Elastography、Liver Disease and Transplantation

OBJECTIVE: MR elastography (MRE) is an MRI-based technique for quantitatively assessing tissue stiffness by studying shear wave propagation through tissue. The goal of this study was to test the hypothesis that hepatic MRE performed before and after a meal will result in a postprandial increase in hepatic stiffness among patients with hepatic fibrosis because of transiently increased portal pressure. SUBJECTS AND METHODS: Twenty healthy volunteers and 25 patients with biopsyproven hepatic fibrosis were evaluated. Preprandial MRE measurements were performed after overnight fasting. A liquid test meal was administered, and 30 minutes later a postprandial MRE acquisition was performed. Identical imaging parameters and analysis regions of interest were used for pre- and postprandial acquisitions. RESULTS: The results in the 20 subjects without liver disease showed a mean stiffness change of 0.16 ± 0.20 kPa (range, -0.12 to 0.78 kPa) or 8.08% ± 10.33% (range, -5.36% to 41.7%). The hepatic stiffness obtained in the 25 patients with hepatic fibrosis showed a statistically significant increase in postprandial liver stiffness, with mean augmentation of 0.89 ± 0.96 kPa (range, 0.17-4.15 kPa) or 21.24% ± 14.98% (range, 7.69%-63.3%). CONCLUSION: MRE-assessed hepatic stiffness elevation in patients with chronic liver disease has two major components: a static component reflecting structural change or fibrosis and a dynamic component reflecting portal pressure that can increase after a mea...