Usefulness of MR elastography for detecting clinical progression of cirrhosis from child-pugh class A to B in patients with type C viral hepatitis

Abstract

Purpose: To evaluate the usefulness of magnetic resonance elastography (MRE) in detecting the clinical progression of cirrhosis from Child-Pugh class A to B in patients with hepatitis C.

Materials and methods: We reviewed the data of 101 consecutive patients with type C viral hepatitis and clinically suspected cirrhosis who fulfilled the all following criteria: available MRE at 1.5 Tesla (T) or 3.0T and laboratory tests within a month, Child-Pugh class A, platelet count less than 155 × 10(3) /μL, no clinical history of hepatocellular carcinoma, and ≥6 months of follow-up after MRE. We longitudinally analyzed the incidence of cirrhosis progression as defined by the clinical progression from Child-Pugh class A to B at two subsequent follow-up points. Risk of cirrhosis progression was assessed by Cox analyses and Kaplan-Meyer methods.

Results: Cirrhosis progression was noted in 25 patients during the follow-up period. Liver stiffness (hazard ratio [HR] by 1 kPa increase = 1.397; P = 0.0074), Child-Pugh score of 6 versus score 5 (HR of 3.085; P = 0.0276), and treatment responses to anti-viral therapy versus nonresponse (HR of <0.001, P = 0.0006) were independent risk factors of cirrhosis progression. The 1-year risk (0.7%; 95% confidence interval, 0.1-4.2%) of cirrhosis progression was negligible in patients with liver stiffness of <3.3 kPa or response to anti-viral treatment.

Conclusion: MRE is useful to stratify the risk of cirrhosis progression in patients with hepatitis C. J. Magn. Reson. Imaging 2016;44:715-722.

Keywords: cirrhosis; elastography; magnetic resonance imaging; prognosis; type C hepatitis.