J.J.CHENG1, H.M.LIM1, J.J.LIU1, C.H.TAN1, K.C.YEW1
Tan Tock Seng Hospital1
Transient elastography (TE) has similar limitations to liver biopsy in accuracy of assessment of general liver stiffness (LS) as each method only measures a fraction of the whole liver volume. This approach is suboptimal in ruling out significant fibrosis.
Retrospective analysis on MRE images of 171 subjects was performed. Four planes of MRE images were selected and region of interests (ROI) were drawn to measure LS. Blood vessels, bile ducts and areas near to the heart were excluded. Each plane consisted of ROIs at 12 different points within the right liver lobe divided into outer, middle, and inner bands (four points/band). Generalized measurements were also made of the 3 bands. We compared differences in LS horizontally and vertically across bands, as well as the mean of the 4 points within each band.
The most common conditions were non-alcoholic fatty liver disease/steatohepatitis (48%) and chronic hepatitis B (20%). Patients were mostly male (64%) Chinese (83%). There was significant difference in LSM between bands of each plane (p < 0.01) and vertically especially in the outer region of the right liver lobe.
There were differences in LS within the right liver lobe both vertically and horizontally. Perhaps TE should not be used as a precise method to exclude significant LS as it only measures the outer 3 cm3 of the liver which would underestimate the prevalence of advanced LS. Vertical differences of LS could explain TE report variability when LSMs are performed across different liver locations during the same assessment period.