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. 2010 Oct;28(8):623-7.
doi: 10.1007/s11604-010-0478-1. Epub 2010 Oct 24.

Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability

Utaroh Motosugi  1 , Tomoaki Ichikawa, Katsuhiro Sano, Hironobu Sou, Ali Muhi, Tsuyota Koshiishi, Richard L Ehman, Tsutomu Araki
Affiliations

Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability

Utaroh Motosugi et al. Jpn J Radiol. 2010 Oct.

Abstract

Purpose: The aim of this study was to estimate inter-rater reliability and validate magnetic resonance elastography (MRE) as a tool to measure liver elasticity.

Materials and methods: The study protocol was approved by the institutional review board at our institution. In all, 10 normal volunteers and 110 patients, who provided written informed consent, were enrolled. The pathological fibrosis score was applied as a standard reference of liver fibrosis in 21 patients. MRE was performed with a 1.5-T magnetic resonance imaging scanner with a cylindrical passive longitudinal shear wave driver placed over the right chest wall to deliver vibrations. A gradient-echo MRE sequence was used to acquire axial wave images, which were automatically converted to elastograms representing elasticity (in kilopascals, or kPa). The region of interest was placed in the right lobe of the liver on elastograms by two raters independently. To evaluate interrater reliability, the intraclass correlation coefficient was calculated. The elasticity measurements correlated with the pathological fibrosis score (F1-F4) in 21 patients.

Results: The intraclass correlation coefficient was almost perfect (0.993) between the elasticities measured by the two raters. The mean elasticity value for patients with F4 was 5.7 kPa; F3, 4.4 kPa; F2, 3.1 kPa; F1, 2.2 kPa; and F0, 2.1 kPa.

Conclusion: MRE is a reliable tool to measure liver elasticity.

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Figures

Figure 1
Figure 1
Histogram of differences (D) in elasticities measured by the 2 raters. Absolute value ofD was <0.8 kPa in more than 95% of the subjects and <0.3 kPa in more than 70% of the subjects.
Figure 2
Figure 2
(a) Elastograms of cases with a pathological fibrosis score of F4 showed high intensity (red color) for almost the entire liver. (b) T1-weighted image corresponding to the elastogram.
Figure 3
Figure 3
(a) In case of a patient with F0, the intensity in the elastograms was low (blue color). (b) T1-weighted image corresponding to the elastogram.
Figure 4
Figure 4
Scattered plot of elasticity by magnetic resonance elastography (MRE) correlated with the pathological fibrosis scores for 21 patients.
See this image and copyright information in PMC

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