Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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The Effect of Gd-EOB-DPTA on the Stiffness Value of Magnetic Resonance Elastography in Evaluating Hepatic Fibrosis

간 섬유화 평가를 위한 MR elastography의 경직도에 대한 Gd-EOB-DTPA의 영향

  • Lee, Jeong Eun (Department of Radiology, Chungnam National University Hospital) ;
  • Lee, Jeong Min (Department of Radiology, College of Medicine Seoul National University) ;
  • Lee, Ye Ji (Department of Radiology, College of Medicine Seoul National University) ;
  • Yoon, Jeong-Hee (Department of Radiology, College of Medicine Seoul National University) ;
  • Lee, Kyung Bun (Department of Pathology, Seoul National University Hospital) ;
  • Han, Joon Koo (Department of Radiology, College of Medicine Seoul National University) ;
  • Choi, Byung Ihn (Department of Radiology, College of Medicine Seoul National University)
  • 이정은 (충남대학교병원 영상의학과) ;
  • 이정민 (서울대학교병원 영상의학과) ;
  • 이예지 (서울대학교병원 영상의학과) ;
  • 윤정희 (서울대학교병원 영상의학과) ;
  • 이경분 (서울대학교병원 병리과) ;
  • 한준구 (서울대학교병원 영상의학과) ;
  • 최병인 (서울대학교병원 영상의학과)
  • Received : 2013.08.01
  • Accepted : 2013.09.04
  • Published : 2013.09.30
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Abstract

Purpose : To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE) used to evaluate hepatic fibrosis (HF). Materials and Methods: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity, and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF (${\geq}F2$) using cut off value of 3.1 kPa. Results: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity, and specificity of the pre- and post-contrast MREs for differentiating significant HF (${\geq}F2$) from ${\geq}F1$ were same as 71%, 60%, and 100%, respectively. Conclusion: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.

목적: 간 섬유화를 평가하기 위한 MR elastography (MRE)의 경직도 (stiffness value)에 미치는 gadoxetic acid의 영향을 평가하고자 하였다. 대상과 방법: 임상적으로 만성 간 질환이 의심되어 자기공명영상을 촬영한 환자 중 조영제 (gadoxetic acid) 주입전과 후에 MRE를 촬영한 32명의 환자를 대상으로 하였다. 두 명의 영상의학과 의사가 간 실질의 경직도를 개별적으로 측정 하였다. 조영 전과 후의 평균 간경직도를 paired t-test를 사용하여 비교하였으며, 평가자내 및 평가자간 상관 관계는 intraclass correlation coefficient (ICC)를 사용하여 분석 하였다. MRE의 F2 이상의 간섬유화 진단의 판별수치로 3.1 kPa을 이용하여 진단의 정확도, 민감도, 특이도를 구하였다. 결과: 조영 전과 후에 측정된 간 경직도의 평균값은 유의한 차이가 없었으며 (p > 0.05), 조영 전 후 모두에서 평가자 내 및 평가자간 우수한 상관 관계가 관찰되었다 (ICC = 0.988 for pre-contrast and ICC = 0.993 for post-contrast, ICC = 0.998 for rater 1 and ICC = 0.996 for rater 2). 간섬유화정도 F2 이상을 진단하는 MRE 의 정확도, 민감도, 특이도는 조영 전후 모두에서 각각 71%, 60%, 그리고 100%로 같은 값을 보였다. 결론: MRE를 이용한 gadoxetic acid 조영 전과 후에 측정된 간경직도는 유의한 차이를 보이지 않았기에 조영 후 MRE 영상도 간 섬유화 평가에 이용될 수 있다.

Keywords

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