Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease

Meng Yin, Jayant A. Talwalkar, Kevin J. Glaser, Sudhakar K Venkatesh, Jun Chen, Armando Manduca, Richard Lorne Ehman

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Abstract

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 biopsy-proven 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 meal. These findings will provide motivation for further studies to determine the potential value of assessing postprandial hepatic stiffness augmentation for predicting the progression of fibrotic disease and the development of portal hypertension. The technique may also provide new insights into the natural history and pathophysiology of chronic liver disease.

Original languageEnglish (US)
Pages (from-to)64-70
Number of pages7
JournalAmerican Journal of Roentgenology
Volume197
Issue number1
DOIs
StatePublished - Jul 2011

Fingerprint

Elasticity Imaging Techniques
Liver Diseases
Chronic Disease
Liver
Fibrosis
Meals
Portal Pressure
Portal Hypertension
Natural History
Disease Progression
Motivation
Fasting
Healthy Volunteers
Biopsy

Keywords

  • Hepatic stiffness
  • MR elastography
  • Perfusion
  • Postprandial augmentation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{22a0b258e4ae41b2a54e8b9e28709a31,
title = "Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease",
abstract = "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 biopsy-proven 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 meal. These findings will provide motivation for further studies to determine the potential value of assessing postprandial hepatic stiffness augmentation for predicting the progression of fibrotic disease and the development of portal hypertension. The technique may also provide new insights into the natural history and pathophysiology of chronic liver disease.",
keywords = "Hepatic stiffness, MR elastography, Perfusion, Postprandial augmentation",
author = "Meng Yin and Talwalkar, {Jayant A.} and Glaser, {Kevin J.} and Venkatesh, {Sudhakar K} and Jun Chen and Armando Manduca and Ehman, {Richard Lorne}",
year = "2011",
month = "7",
doi = "10.2214/AJR.10.5989",
language = "English (US)",
volume = "197",
pages = "64--70",
journal = "American Journal of Roentgenology",
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T1 - Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease

AU - Yin, Meng

AU - Talwalkar, Jayant A.

AU - Glaser, Kevin J.

AU - Venkatesh, Sudhakar K

AU - Chen, Jun

AU - Manduca, Armando

AU - Ehman, Richard Lorne

PY - 2011/7

Y1 - 2011/7

N2 - 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 biopsy-proven 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 meal. These findings will provide motivation for further studies to determine the potential value of assessing postprandial hepatic stiffness augmentation for predicting the progression of fibrotic disease and the development of portal hypertension. The technique may also provide new insights into the natural history and pathophysiology of chronic liver disease.

AB - 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 biopsy-proven 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 meal. These findings will provide motivation for further studies to determine the potential value of assessing postprandial hepatic stiffness augmentation for predicting the progression of fibrotic disease and the development of portal hypertension. The technique may also provide new insights into the natural history and pathophysiology of chronic liver disease.

KW - Hepatic stiffness

KW - MR elastography

KW - Perfusion

KW - Postprandial augmentation

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