T1 relaxation time in the evaluation of liver fibrosis; with native MR relaxometry

Year 2023, Volume: 36 Issue: 2, 197 - 202, 31.05.2023

Firathan Sarıaltın , Hasan Yıgıt Elif Ergun Pinar Nercis Kosar

https://doi.org/10.5472/marumj.1302518

Abstract

Objective: Non-invasive methods have been investigated as an alternative to biopsy in assessing liver fibrosis. This study aimed to
evaluate the relationship between liver T1 relaxation time and liver fibrosis as a non-invasive alternative method.
Patients and Methods: This study analyzed 1.5T magnetic resonance (MR) images of 86 patients retrospectively. The participants were
divided into two groups: patients with chronic hepatitis and the control group. Native variable flip angle (VFA) T1 mapping technique
was used to estimate liver T1 relaxation time. T1 mapping sequence, T2* mapping sequence, and image analysis were performed. The
liver size, the spleen size, the liver T1 relaxation time, and the liver T2* relaxation time were recorded.
Results: The T1 relaxation time was 758.4 ± 121.1 ms in the chronic hepatitis group and 600.2 ± 67 ms in the control group. The T1
relaxation time of the patient group was significantly higher than that of the control group (p<0.001). The spleen size of the patient
group was statistically significantly larger than the control group (p<0.001). There was a significant positive correlation between liver
T1 relaxation time and Ishak score (r=0.683, p<0.001). Also, a significant positive correlation was observed between T1 relaxation time
and histological activity index score (r=0.542, p<0.001).
Conclusion: A native T1 map is a non-invasive method that works as an alternative to biopsy in the follow-up and diagnosis of chronic
hepatitis. Moreover, this method can be used to measure liver T1 relaxation time in patients with liver fibrosis.

Keywords

Fibrosis, Liver, MRI, Relaxometry, T1

References

• [1] Moon AM, Singal AG, Tapper EB. Contemporary epidemiology of chronic liver disease and cirrhosis. Clin Gastroenterol Hepatol 2020;18:2650-66. doi:10.1016/j.cgh.2019.07.060
• [2] Tanwar S, Rhodes F, Srivastava A, Trembling PM, Rosenberg WM. Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C. World J Gastroenterol 2020;26:109-33. doi:10.3748/wjg. v26.i2.109
• [3] Sripongpun P, Pongpaibul A, Charatcharoenwitthaya P. Value and risk of percutaneous liver biopsy in patients with cirrhosis and clinical suspicion of autoimmune hepatitis. BMJ Open Gastroenterol 2021;8:e000701. doi:10.1136/ bmjgast-2021-000701
• [4] Mulazzani L Terzi E, Casadei G, et al. Retrospective analysis of safety of ultrasound-guided percutaneous liver biopsy in the 21st century. Eur J Gastroenterol Hepatol 2021;33(1S Suppl 1):e355-e362. doi:10.1097/MEG.000.000.0000002080
• [5] Mathew RP, Venkatesh SK. Imaging of hepatic fibrosis. Curr Gastroenterol Rep 2018;20:45. doi:10.1007/s11894.018.0652-7
• [6] Hoffman DH, Ayoola A, Nickel D, et al. MR elastography, T1 and T2 relaxometry of liver: role in noninvasive assessment of liver function and portal hypertension. Abdom Radiol (NY) 2020;45:2680-7. doi:10.1007/s00261.020.02432-7
• [7] Carneiro AAO, Vilela GR, De Araujo DB, Baffa O. MRI relaxometry: methods and applications. Brazilian journal of physics 2006; 36:9-15. doi: doi.org/10.1590/ S0103.973.3200600.010.0005
• [8] Anderson LJ, Holden S, Davis B, et al. Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 2001;22:2171-9. doi:10.1053/ euhj.2001.2822
• [9] Henninger B, Kremser C, Rauch S, et al. Evaluation of MR imaging with T1 and T2* mapping for the determination of hepatic iron overload. Eur Radiol 2012;22:2478-86. doi:10.1007/s00330.012.2506-2
• [10] Iles L, Pfluger H, Phrommintikul A, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J Am Coll Cardiol 2008;52:1574-80. doi:10.1016/j.jacc.2008.06.049
• [11] Schabel MC, Morrell GR. Uncertainty in T(1) mapping using the variable flip angle method with two flip angles. Phys Med Biol 2009;54:N1-N8. doi:10.1088/0031-9155/54/1/N01
• [12] Ding Y, Rao SX, Zhu T, Chen CZ, Li RC, Zeng MS. Liver fibrosis staging using T1 mapping on gadoxetic acid-enhanced MRI compared with DW imaging. Clin Radiol 2015;70:1096- 1103. doi:10.1016/j.crad.2015.04.014
• [13] Li Z, Sun J, Hu X, et al. Assessment of liver fibrosis by variable flip angle T1 mapping at 3.0T. J Magn Reson Imaging 2016;43:698-703. doi:10.1002/jmri.25030
• [14] Ferreira VM, Piechnik SK, Dall’Armellina E, et al. Noncontrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: a comparison to T2-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012;14:42. doi:10.1186/1532-429X-14-42
• [15] Obrzut M, Atamaniuk V, Glaser KJ, et al. Value of liver iron concentration in healthy volunteers assessed by MRI. Sci Rep 2020;10:17887. doi:10.1038/s41598.020.74968-z
• [16] Erden A, Kuru Öz D, Peker E, et al. MRI quantification techniques in fatty liver: the diagnostic performance of hepatic T1, T2, and stiffness measurements in relation to the proton density fat fraction. Diagn Interv Radiol 2021;27:7-14. doi:10.5152/dir.2020.19654
• [17] Venkatesh SK, Wang G, Lim SG, Wee A. Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol 2014;24:70-8. doi:10.1007/ s00330.013.2978-8
• [18] Huwart L, Peeters F, Sinkus R, et al. Liver fibrosis: non-invasive assessment with MR elastography. NMR Biomed 2006;19:173- 9. doi:10.1002/nbm.1030
• [19] Cassinotto C, Feldis M, Vergniol J, et al. MR relaxometry in chronic liver diseases: Comparison of T1 mapping, T2 mapping, and diffusion-weighted imaging for assessing cirrhosis diagnosis and severity. Eur J Radiol 2015;84:1459-65. doi:10.1016/j.ejrad.2015.05.019
• [20] de Bazelaire CM, Duhamel GD, Rofsky NM, Alsop DC. MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results. Radiology 2004;230:652-9. doi:10.1148/radiol.230.302.1331
• [21] Banerjee R, Pavlides M, Tunnicliffe EM, et al. Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease. J Hepatol 2014;60:69-77. doi:10.1016/j. jhep.2013.09.002
• [22] Haimerl M, Verloh N, Zeman F, et al. Assessment of clinical signs of liver cirrhosis using T1 mapping on Gd-EOB-DTPAenhanced 3T MRI. PLoS One. 2013;8:e85658. doi:10.1371/ journal.pone.0085658
• [23] Chandarana H, Lim RP, Jensen JH, et al. Hepatic iron deposition in patients with liver disease: preliminary experience with breath-hold multiecho T2*-weighted sequence. AJR Am J Roentgenol 2009;193:1261-7. doi:10.2214/AJR.08.1996
• [24] Anderson LJ, Holden S, Davis B, et al. Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 2001;22:2171-9. doi:10.1053/ euhj.2001.2822
• [25] Pepe A, Lombardi M, Positano V, et al. Evaluation of the efficacy of oral deferiprone in beta-thalassemia major by multislice multiecho T2*. Eur J Haematol 2006;76:183-92. doi:10.1111/j.1600-0609.2005.00587.x