Simultaneous evaluation of perfusion and morphology using GRASP MRI in hepatic fibrosis

Objectives To determine if golden-angle radial sparse parallel (GRASP) dynamic contrast-enhanced (DCE)-MRI allows simultaneous evaluation of perfusion and morphology in liver fibrosis. Methods Participants who were scheduled for liver biopsy or resection were enrolled (NCT02480972). Images were reconstructed at 12-s temporal resolution for morphologic assessment and at 3.3-s temporal resolution for quantitative evaluation. The image quality of the morphologic images was assessed on a four-point scale, and the Liver Imaging Reporting and Data System score was recorded for hepatic observations. Comparisons were made between quantitative parameters of DCE-MRI for the different fibrosis stages, and for hepatocellular carcinoma (HCCs) with different LR features. Results DCE-MRI of 64 participants (male = 48) were analyzed. The overall image quality consistently stood at 3.5 +/- 0.4 to 3.7 +/- 0.4 throughout the exam. Portal blood flow significantly decreased in participants with F2-F3 (n = 18, 175 +/- 110 mL/100 mL/min) and F4 (n = 12, 98 +/- 47 mL/100 mL/min) compared with those in participants with F0-F1 (n = 34, 283 +/- 178 mL/100 mL/min, p < 0.05 for all). In participants with F4, the arterial fraction and extracellular volume were significantly higher than those in participants with F0-F1 and F2-F3 (p < 0.05). Compared with HCCs showing non-LR-M features (n = 16), HCCs with LR-M (n = 5) had a significantly prolonged mean transit time and lower arterial blood flow (p < 0.05). Conclusions Liver MRI using GRASP obtains both sufficient spatial resolution for confident diagnosis and high temporal resolution for pharmacokinetic modeling. Significant differences were found between the MRI-derived portal blood flow at different hepatic fibrosis stages.

Automated summary

The study demonstrates that liver MRI using GRASP technique can provide sufficient spatial resolution for confident diagnosis and high temporal resolution for pharmacokinetic modeling. Significant differences in MRI-derived portal blood flow were found at different hepatic fibrosis stages.