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DIFFUSE LIVER DISEASE. Dr. Bengt Norén M. D, Med Lic. Dep. of Radiology and CMIV University Hospital Linköping. BN 20111207. BN 20111207. BN 20111207. Conventional Biopsy. Inflammation. Fibrosis grading – Biopsy F0- F4 ( Batts and Ludwig ) Grouped into : F0 – F2 F3 – F4.
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DIFFUSE LIVER DISEASE Dr. Bengt Norén M. D, Med Lic. Dep. of Radiology and CMIV University Hospital Linköping BN 20111207
Conventional Biopsy • Inflammation Fibrosis grading – Biopsy F0- F4 (Batts and Ludwig) Grouped into : F0 – F2 F3 – F4 • Fibrosis/cirrhosis • Steatosis • Fe BN 20111207
Non Invasive Liver Biopsy ”NILB” 1.31 P MRS 2. DCE-MRI BN 20111207
Fibrosis/cirrhosis ; 31 P MRS BN 20111207
Fibrosis/cirrhosis ; 31 P MRS I Conc mM Anabolic charge (AC) : [PME] / ([PME] + [PDE]) Patients had a significant larger AC than the control subjects, 0.29 vs 0.16 (p 0.005). PME Pi ATPb PDE BN 20111207 Noren et al European Radiology,2005, 15(1), 148-157.
Fibrosis/cirrhosis ; 31 P MRS II BN 20111207
Fibrosis/cirrhosis ; 31 P MRS II AC Group BN 20111207
Fibrosis/cirrhosis ; 31 P MRS II Degree of fibrosis predicted from AC P = 0.0097. Fisher’s exact test AC cut-off value of 0.27 showed a sensitivity of 93% and a specificity of 54 %. BN 20111207 Noren et al European Journal of Radiology, 2008, 66(2), 313-320
Fibrosis/cirrhosis; DCE-MRI Can we identify and separate different stages of fibrosis by quantitatively measure the uptake of Gd-EOB-DTPA (Primovist)using DCE-MRI ? BN 20111207
Fibrosis/cirrhosis; DCE-MRI Prospective study. • 38 patients ( 21 men, 17 women) • Pathological liver function tests • Liver biopsy BN 20111207
Fibrosis/cirrhosis; DCE-MRI • 1.5 T MR (Achieva, Philips Medical Systems ) • T1-weighted 3D GRE (native, arterial and venous portal phase; 3, 10, 20 and 30 min) KHep – contrast uptake rate LSC_N10 and LSC_N20 LSC10 and LSC20 BN 20111207
Fibrosis/cirrhosis; DCE-MRI BN 20111207
NILB ”Multi parameter Q - MR approach” Biopsy MR techniques; • Inflammation ? • MRS - 31P • MRS - 1 H • DCE- MRI • MRE • T2/T2* • Diffusion • Fibrosis/cirrhosis • Steatosis • Fe BN 20111207