Objective: To evaluate the value of MR liver extracellular volume (ECVliver) in assessment of liver fibrosis with chronic hepatitis B (CHB), and to compare its performance with two-dimensional (2D) shear-wave elastography (SWE).
Materials and methods: A total of 68 CHB patients who were histologically diagnosed as fibrosis stages F0 to F4 were retrospectively analyzed. All patients underwent gadopentetate dimeglumine-enhanced T1-mapping and 2D SWE. ECVliver and liver stiffness were measured and compared between fibrosis subgroups; their correlations with histologic findings were evaluated using Spearman correlation test and multiple regression analysis. Diagnostic performance in evaluating liver fibrosis stages was assessed and compared using receiver-operating characteristic analysis.
Results: Both ECVliver and liver stiffness increased as the fibrosis score increased (F = 17.08 to 10.99, P < 0.001). ECVliver displayed a strong correlation with fibrosis stage (r = 0.740, P < 0.001), and liver stiffness displayed a moderate correlation (r = 0.651, P < 0.001); multivariate analysis revealed that only ECVliver was independently correlated with fibrosis stage (P < 0.001). Univariate analyses showed significant correlations of ECVliver with fibrosis stage, inflammatory activity, and platelet count; among all, the fibrosis stage had the highest correlation coefficient and was the only independent factor (P < 0.001). Overall, ECVliver had no significant different performance compared with 2D SWE for the identification of both fibrosis stage s ≥ F2 and F4 (P = 0.868 and 0.171).
Conclusion: MR ECVliver plays a promising role in the prediction of liver fibrosis for patients with CHB, comparable to 2D SWE.
Keywords: Chronic hepatitis B; Cirrhosis; Extracellular space; Liver fibrosis; Magnetic resonance imaging; Sonoelastography.