Hepatitis activity should be considered a confounder of liver stiffness measured with MR elastography
S Ichikawa, U Motosugi, T Nakazawa… - Journal of Magnetic …, 2015 - Wiley Online Library
S Ichikawa, U Motosugi, T Nakazawa, H Morisaka, K Sano, T Ichikawa, N Enomoto…
Journal of Magnetic Resonance Imaging, 2015•Wiley Online LibraryPurpose To evaluate the effect of hepatitis activity on liver stiffness measurements and the
role of serum alanine aminotransferase (ALT) in liver fibrosis staging by MR elastography
(MRE). Materials and Methods We measured liver stiffness (kPa) in 135 patients by MRE
and histologically assessed fibrosis and hepatitis activity within 2 months. Stepwise multiple
linear regression was performed to determine the maximum adjusted R2 against liver
stiffness, after adjusting for nothing (model 1), ALT/upper limit of normal categories (model …
role of serum alanine aminotransferase (ALT) in liver fibrosis staging by MR elastography
(MRE). Materials and Methods We measured liver stiffness (kPa) in 135 patients by MRE
and histologically assessed fibrosis and hepatitis activity within 2 months. Stepwise multiple
linear regression was performed to determine the maximum adjusted R2 against liver
stiffness, after adjusting for nothing (model 1), ALT/upper limit of normal categories (model …
Purpose
To evaluate the effect of hepatitis activity on liver stiffness measurements and the role of serum alanine aminotransferase (ALT) in liver fibrosis staging by MR elastography (MRE).
Materials and Methods
We measured liver stiffness (kPa) in 135 patients by MRE and histologically assessed fibrosis and hepatitis activity within 2 months. Stepwise multiple linear regression was performed to determine the maximum adjusted R2 against liver stiffness, after adjusting for nothing (model 1), ALT/upper limit of normal categories (model 2), and hepatitis activity (A grade) by METAVIR (model 3). Logistic regression was used to identify independent factors associated with pathologically proven cirrhosis.
Results
Platelet count and METAVIR F score were strongly associated with liver stiffness. The adjusted R2 value of model 3 (0.7026) was higher than those of models 1 (0.6472) and 2 (0.6564), showing that hepatitis activity affected liver stiffness measurement. High ALT levels (odds ratio, 0.0066; P = 0.0003) as well as MRE (odds ratio, 9.91; P < 0.0001) were independently associated with cirrhosis.
Conclusion
Hepatitis activity may be a confounder of liver stiffness measurement during liver fibrosis staging using MRE. MRE can potentially make an overdiagnosis of liver cirrhosis if the patient has high ALT levels. J. Magn. Reson. Imaging 2015;41:1203–1208. © 2014 Wiley Periodicals, Inc.
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