The feasibility of proton Magnetic Resonance Spectroscopy at 3T for hepatic choline quantification and its correlation with dietary intake in young women, a population at risk of nutrient-sensitive liver conditions, is evaluated.
Hepatic venous pressure gradient (HVPG) is the gold standard for assessing portal hypertension (PH). We previously demonstrated that a bivariate MRI model combining liver T1 and splenic artery velocity at 1.5 T correlates with HVPG. This study aimed to evaluate this model at 3 T and investigate additional splanchnic MRI measures as potential non‐invasive markers of portal pressure. Data from 40 participants (15 metabolic dysfunction–associated steatotic liver disease [MASLD]/13 alcohol‐related liver disease [ArLD]/12 other, 55 ± 14 years) scanned at 1.5 T (retrospective) and 42 participants (21 MASLD/14 ArLD/7 other, 60 ± 12 years) scanned prospectively at 3 T who underwent clinical HVPG measurement were analysed. Liver and spleen iron‐corrected T1 (cT1) were acquired using fat‐suppressed spin‐echo echo‐planar T1 mapping, and splanchnic haemodynamics were assessed using phase‐contrast MRI. Correlations between MRI parameters and HVPG were assessed, and previously derived univariate (liver cT1) and bivariate (liver cT1 + splenic artery velocity) models were evaluated using receiver operating characteristic (ROC) analysis for PH (HVPG ≥ 5 mmHg), clinically significant PH (CSPH; HVPG ≥ 10 mmHg) and increased risk of mortality (HVPG ≥ 15 mmHg). Liver cT1 at 3 T showed a strong positive correlation with HVPG across the full range (0–23 mmHg; R = 0.73, p < 0.0001). After field adjustment, pooled 1.5 and 3 T liver cT1 maintained a strong correlation with HVPG (R = 0.76, p < 0.0001). At 3 T, the univariate liver cT1 model outperformed the bivariate model, achieving AUROCs of 0.74, 0.86 and 0.91 for detecting PH, CSPH and HVPG ≥ 15 mmHg, respectively. In contrast, spleen cT1 and superior mesenteric artery velocity correlated with HVPG only up to ~15 mmHg, after which values plateaued or declined. Liver cT1 MRI at 3 T provides a surrogate of portal pressure across the full HVPG range and outperforms a previously proposed bivariate model. Spleen and splanchnic haemodynamic measures demonstrate a ceiling effect at higher portal pressures > 15 mmHg.
Christopher R Bradley, R. Scott, Eleanor F. Cox et al.· NMR in Biomedicine· 0 citations
Objective:
To determine the diagnostic efficacy of proton magnetic resonance spectroscopy (
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H-MRS) in the management algorithm for critically ill patients with chronic hepatitis of various etiologies.
Material and methods.
This prospective study (2023–2025, Clinical Hospital No. 1, Smolensk) included 30 intensive care unit (ICU) patients with chronic hepatitis (main group) and 21 conditionally healthy volunteers (control group). All participants underwent abdominal ultrasound and magnetic resonance imaging (1.5 T) with
1
H-MRS (PRESS, TE 35 ms, TR 1600 ms, voxel size 17×17×17 mm) for quantitative assessment of N-acetylaspartate (NAA), lipids (Lip), lactate (Lac), aspartate (Asp), and choline (Chol). Patients in the main group underwent
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H-MRS twice: at admission and after 6 months of therapy. Statistical analysis included the Mann–Whitney U test, Spearman’s correlation (ρ), ROC analysis, logistic regression, and Fisher’s exact test; the significance level was set at p<0.05.
Results.
ICU patients showed statistically significant (p<0.01) metabolic changes compared to controls: increased Lip (11.5 [9.8; 13.2] c.u.; 86.7% of patients), Lac (49.8 [48.5; 51.2] c.u.; 100%), Asp (4.0 [2.5; 5.0] c.u.; 60%); decreased NAA (–0.8 [–1.5; –0.1] c.u.; 73.3%), and Chol (0.9 [0.2; 2.1] c.u.). The NAA/Lip ratio was below 1 c.u. in 80% of patients (median 0.32 [0.21; 0.48]). ROC analysis showed that NAA/Lip predicts the development of cirrhosis (F4) at 6 months with AUC 0.94 (95% confidence interval (CI) 0.85–0.98); the optimal cut-off value was ><0.95 c.u. (sensitivity 95.8%, specificity 83.3%). All 24 patients with baseline NAA/Lip below the cut-off developed cirrhosis F4 at 6 months. The correlation between NAA/Lip and fibrosis stage was strongly negative (>ρ=–0.89; 95% CI –0.95...–0.77). Chol <1.8 c.u. was also associated with cirrhosis development (AUC 0.88; odds ratio 19.0; 95% CI 2.8–128; p=0.003). Elevated Asp (>2.5 c.u.) was found in 18 (60%) patients; among them, 10 (55.5%) subsequently developed hepatocellular insufficiency (p=0.003, Fisher’s exact test; ρ=0.64).
Conclusion.
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H-MRS is a valuable non-invasive method for assessing metabolic disorders in ICU patients with chronic hepatitis. The NAA/Lip ratio (cut-off <0.95 c.u.), as well as Chol and Asp levels, have high prognostic value for the risk of fibrosis progression to cirrhosis and the development of hepatocellular insufficiency. The method can be used to personalize therapy in situations where invasive biopsy is contraindicated.><0.95 c.u.), as well as Chol and Asp levels, have high prognostic value for the risk of fibrosis progression to cirrhosis and the development of hepatocellular insufficiency. The method can be used to personalize therapy in situations where invasive biopsy is contraindicated.
A. Orekhovskaya, T. G. Morozova· Journal of radiology and nuc...· 0 citations
BACKGROUND
MR elastography (MRE) has applications in breast cancer, but its optimal frequency and value in discriminating molecular subtypes remain unclear.
PURPOSE
To identify the preferable breast MRE frequency and evaluate MRE parameters in the precision diagnosis of breast cancer.
STUDY TYPE
Prospective.
POPULATION
One hundred fifty-four female patients (mean age 50 ± 10.67 years) were enrolled, including five with bilateral cancer, yielding 159 lesions.
FIELD STRENGTH/SEQUENCE
3.0 T, fast gradient-echo for DCE-MRI, single-shot EPI for DWI/ADC, SE-EPI for multifrequency MRE.
ASSESSMENT
The image quality of 10 frequency MRE sets was assessed (including overall image quality, diagnostic confidence, artifact impact, and signal-to-noise ratio). Stiffness (c) and viscosity (φ) were measured at the optimal frequency and compared across clinicopathological subgroups.
STATISTICAL TESTS
Independent-sample t-tests or one-way analysis of variance, Mann-Whitney U or Kruskal-Wallis H tests, Friedman test, χ2 tests. Spearman's rank correlation. Univariate and multivariate analyses. Receiver operating characteristic (ROC) curves, the area under the curve (AUC). p < 0.05 was considered statistically significant.
RESULTS
The 40-70 Hz multifrequency band demonstrated significantly superior image quality compared with all other bands. Subgroup analyses showed that c and φ differed significantly between ER-positive and ER-negative groups (c values: 2.54 (2.17-2.86) vs. 2.80 (2.37-3.30) m/s; φ values: 1.17 ± 0.21 vs. 1.24 ± 0.22 radians) and across groups with different Ki-67 expression levels (c values: 2.54 ± 0.54 vs. 2.77 ± 0.57 m/s), T stage, molecular subtypes (c values: 2.55 (2.20-2.82) vs. 2.69 (2.20-2.96) vs. 2.94 (2.52-3.33) m/s), and enhancement patterns (c values: 2.34 ± 0.41 vs. 2.73 ± 0.58 m/s). Multivariable analysis identified c [OR: 5.37 (2.13-15.54)] and age group [OR: 0.27 (0.09-0.82)] as significant independent predictors of triple-negative breast cancer, and a predictive model incorporating these variables demonstrated an AUC of 0.739 in the training set and 0.700 in the validation set.
DATA CONCLUSION
The 40-70 Hz multifrequency protocol may offer favorable image quality for breast MRE. MRE parameters, particularly stiffness, show potential for characterizing tissue biomechanical properties and could assist in distinguishing molecular subtypes.
EVIDENCE LEVEL
1.
STAGE OF TECHNICAL EFFICACY
Stage 2.
Xiaowen Ma, Yifeng Chen, Jinlong Zheng et al.· Journal of Magnetic Resonanc...· 1 citation
OBJECTIVE
This study aimed to investigate the applicability of MRI proton density fat fraction (MRI-PDFF) and extracellular volume fraction (ECV) in detecting liver injury in patients with intestinal Crohn's disease (CD). Additionally, it evaluated the relationships among multi-parametric imaging indicators, clinical scores, and serological markers.
METHODS
A total of 107 patients with CD were enrolled in this retrospective study conducted from December 2021 to October 2024. All subjects underwent MRI scans with Iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) sequence to generate the MRI-PDFF values. Moreover, pre- and post-contrast liver T1 mapping was performed at the level of the liver hilum. The ECV value was calculated by inputting the patient's hematocrit level (HCT). Based on the Harvey-Bradshaw index (HBI), the clinical score was assessed along with serological markers, including alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST), erythrocyte sedimentation rate (ESR), fecal calprotectin (FC), and γ-glutamyl transferase (GGT). Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the application value of ECV and MRI-PDFF value compared with ALP, ALT, AST, ESR, FC, and GGT. The correlation of the ECV and MRI-PDFF values with clinical score and serological markers was assessed using correlation coefficients.
RESULTS
In examining different levels of intestinal inflammation activity, significant statistical differences were observed in MRI-PDFF and ECV values (p < 0.001). ROC curve analysis indicated that MRI-PDFF and ECV exhibited superior discriminatory abilities, with AUCs of 0.773 and 0.843, respectively (ALP, ALT, AST, GGT, ESR, and FC of 0.512, 0.566, 0.530, 0.551, 0.693, 0.716). Both MRI-PDFF values (r = 0.520, r = 0.246, r = 0.339, all p < 0.001) and ECV (r = 0.534, r = 0.435, r = 0.433, all p < 0.001) were positively correlated with HBI, ESR, and FC values.
CONCLUSION
This study suggests that chronic systemic inflammation may lead to liver injury in patients with CD. Liver MRI can help assess and monitor liver involvement that may not be visually detectable in these patients.
CLINICAL TRIAL NUMBER
Not applicable.
Luanxin Zhu, Zhiheng Zhang, Yuping Ma et al.· BMC Medical Imaging· 0 citations
Qualitative similarities between volume measurements in adults and the questions of reproducibility through test-retest reliability and external validity using recent software updates to the Hyperfine Swoop system constitute a crucial foundation for the clinical utility of 64 mT MRI in monitoring brain volume loss over time.
M. Stockbridge, Rex Wang, V. Neal et al.· Aperture Neuro· 0 citations
CS-MPRAGE provides high-quality 3D images and reliable volume data with significantly reduced acquisition time and comparable image quality by comparing its scan time and image quality with standard MPRAGE.