Magnetic resonance elastography of the liver: Qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences

Mathilde Wagner, Cecilia Besa, Jad Bou Ayache, Temel Kaya Yasar, Octavia Bane, Maggie Fung, Richard L. Ehman, Bachir Taouli

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Objective: The aim of this study was to compare 2-dimensional (2D) gradient recalled echo (GRE) and 2D spin echo echoplanar imaging (SE-EPI) magnetic resonance elastography (MRE) sequences of the liver in terms of image quality and quantitative liver stiffness (LS) measurement. Materials and Methods: This prospective study involved 50 consecutive subjects (male/female, 33/17; mean age, 58 years) who underwent liver magnetic resonance imaging at 3.0 T including 2 MRE sequences, 2D GRE, and 2D SE-EPI (acquisition time 56 vs 16 seconds, respectively). Image quality scores were assessed by 2 independent observers based on wave propagation and organ coverage on the confidence map (range, 0-15). A third observer measured LS on stiffness maps (in kilopascal). Mean LS values, regions of interest size (based on confidence map), and image quality scores between SE-EPI and GRE-MRE were compared using paired nonparametric Wilcoxon test. Reproducibility of LS values between the 2 sequences was assessed using intraclass coefficient correlation, coefficient of variation, and Bland-Altman limits of agreement. T2 effect on image quality was assessed using partial Spearman correlation. Results: There were 4 cases of failure with GRE-MRE and none with SE-EPI-MRE. Image quality scores and region of interest size were significantly higher using SE-EPI-MRE versus GRE-MRE (P < 0.0001 for both measurements and observers). Liver stiffness measurements were not significantly different between the 2 sequences (3.75 ± 1.87 kPa vs 3.55 ± 1.51 kPa, P = 0.062), were significantly correlated (intraclass coefficient correlation, 0.909), and had excellent reproducibility (coefficient of variation, 10.2%; bias, 0.023; Bland-Altman limits of agreement, -1.19; 1.66 kPa). Image quality scores using GRE-MRE were significantly correlated with T2 while there was no correlation for SE-EPI-MRE. Conclusions: Our data suggest that SE-EPI-MRE may be a better alternative to GRE-MRE. The diagnostic performance of SE-EPI-MRE for detection of liver fibrosis needs to be assessed in a future study.

Original languageEnglish (US)
Pages (from-to)575-581
Number of pages7
JournalInvestigative radiology
Volume51
Issue number9
DOIs
StatePublished - Aug 23 2016

Keywords

  • Gradient recalled echo
  • Liver stiffness
  • Magnetic resonance elastography
  • Spin echo echoplanar

ASJC Scopus subject areas

  • General Medicine

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