Abstract
Objectives
To determine whether T2 map** in liver MRI can predict decompensation and death in cirrhotic patients.
Methods
This retrospective study included 292 cirrhotic patients who underwent gadoxetic acid-enhanced MRI, including T1 and T2 map** at 10-min hepatobiliary phase by using the Look-Locker and radial turbo spin-echo sequences, respectively. T1 and T2 values of the liver and spleen were measured. The association of MR parameters and serum markers with decompensation and death was investigated. Risk models combining T2Liver, serum albumin level, and Model for End-Stage Liver Disease (MELD) score were created for predicting decompensation (T2Liver, < 49.3 versus ≥ 49.3 ms) and death (< 57.4 versus ≥ 57.4 ms).
Results
In patients with compensated cirrhosis at baseline and in the full patient cohort, 9.6% (19 of 197) and 5.1% (15 of 292) developed decompensation and died during the mean follow-up periods of 18.7 and 19.2 months, respectively. A prolonged T2Liver (hazard ratio (HR), 2.59; 95% confidence interval (CI), 1.26, 5.31) was independently predictive of decompensation along with the serum albumin level (HR, 0.28; 95% CI, 0.12, 0.68) and MELD score (HR, 1.34; 95% CI, 1.08, 1.66). T2Liver (HR, 2.61; 95% CI, 1.19, 5.72) and serum albumin level (HR, 0.46; 95% CI, 0.19, 1.14) were independent predictors of death. The mean times to decompensation (12.9 versus 29.2 months) and death (16.5 versus 29.6 months) were significantly different between the high- and low-risk groups (p < 0.001).
Conclusion
T2Liver from T2 map** can predict decompensation and death in patients with cirrhosis.
Key Points
• Liver T2 values from the radial turbo spin-echo (TSE) T2 map** sequence with tiered echo sharing and pseudo golden-angle (pGA) reordering were significantly higher in decompensated cirrhosis than compensated cirrhosis.
• Liver T2 values from the radial TSE T2 map** sequence with tiered echo sharing and pGA reordering can predict decompensation and death in patients with cirrhosis.
• T2 map** is recommended as part of liver MRI examinations for cirrhotic patients because it can provide a noninvasive prognostic marker for the development of decompensation and death.
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Abbreviations
- AIC:
-
Akaike information criterion
- CI:
-
Confidence interval
- CV:
-
Coefficient of variation
- ETL:
-
Echo train length
- HBP:
-
Hepatobiliary phase
- HR:
-
Hazard ratio
- ICC:
-
Intraclass correlation coefficient
- MELD:
-
Model for End-Stage Liver Disease
- pGA:
-
Pseudo golden-angle
- TE:
-
Echo time
- TR:
-
Repetition time
- TSE:
-
Turbo spin-echo
- VB:
-
Variceal bleeding
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Acknowledgements
We acknowledge Professor Rock Bum Kim in Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, **ju, Republic of Korea, for statistical advice for this manuscript.
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The scientific guarantor of this publication is Professor Ji Eun Kim in Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, **ju, Republic of Korea.
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Two of the authors (Fei Han, Marcel Dominik Nickel) are employees of Siemens Healthcare. The rest of the authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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Professor Rock Bum Kim in Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, **ju, Republic of Korea, kindly provided statistical advice for this manuscript.
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• Retrospective
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• Performed at one institution
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Yang, W., Kim, J.E., Choi, H.C. et al. T2 map** in gadoxetic acid-enhanced MRI: utility for predicting decompensation and death in cirrhosis. Eur Radiol 31, 8376–8387 (2021). https://doi.org/10.1007/s00330-021-07805-0
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DOI: https://doi.org/10.1007/s00330-021-07805-0