ABSTRACT
<p><b>BACKGROUND</b>Chronic liver disease causes aberrant formation of fibrous tissue that impedes normal liver function, ultimately resulting in liver cirrhosis. Iron uptake can occur within the hepatic parenchyma or within the various nodules that form in a cirrhotic liver, termed siderotic nodules (SN). We aimed to investigate the diagnostic performance of susceptibility weighted imaging (SWI) for detection of SN in patients with liver cirrhosis, and to evaluate the potential of SN numbers for assessing the degree of hepatic iron deposition, liver function, and liver fibrosis stage.</p><p><b>METHODS</b>Ninety-one patients with chronic liver cirrhosis, who underwent megnetic resonance imagine (MRI) scanning in our department between November 2010 and April 2011, were included in the study. A 3.0T MRI scanner was used to acquire T1WI, T2WI, T2WI, and SWI images. The number of nodules, signal intensity ratio (SIR), and contrast noise ratio (CNR) were recorded and analyzed by chi-square and ANOVA statistical tests. Correlation analysis was performed to evaluate the correlations between the number of SN and Child-Pugh classification, ferritin and hyaluronic acid levels.</p><p><b>RESULTS</b>The sensitivity of SWI, T1WI, T2WI, and T2 WI for detecting SN was 62.5%, 12.1%, 24.2% and 41.8%, respectively. SWI detected significantly more nodules than routine T1WI, T2WI, and T2 WI procedures (P < 0.05). The SIR was the lowest in SWI (0.361 ± 0.209), as compared to T1WI (0.852 ± 0.163), T2WI (0.584 ± 0.172), and T2 WI (0.497 ± 0.196). The CNR was the highest in SWI (13.932 ± 5.637), as compared to T1WI (9.147 ± 5.785), T2WI (9.771 ± 5.490), and T2 WI (11.491 ± 4.573). The correlation coefficients of the number of SN with ferritin, Child-Pugh classification, and hyaluronic acid levels were 0.672, -0.055, and 0.163, respectively.</p><p><b>CONCLUSIONS</b>The sensitivity and contrast of SWI for detecting SN in patients with liver cirrhosis are higher than conventional MRI. The number of SN can help to assess the degree of iron deposition in patients with liver cirrhosis.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Diffusion Magnetic Resonance Imaging , Methods , Ferritins , Blood , Hyaluronic Acid , Blood , Liver , Pathology , Liver Cirrhosis , Blood , Pathology , Sensitivity and SpecificityABSTRACT
<p><b>BACKGROUND</b>Right ventricular (RV) dysfunction ensues due to rheumatic mitral stenosis (RMS). The evaluation of RV function is clinically important for the diagnosis, treatment, and follow-up for patients with different degrees of RMS. The purpose of this study was to determine whether the 64-slice multi-detector row computed tomography (64-slice MDCT) can assess the RV function in RMS with high accuracy and reproducibility when compared to MR imaging (MRI).</p><p><b>METHODS</b>Right ventricular end-diastolic and end-systolic volumes (RV-EDV and RV-ESV), stroke volume (RV-SV), ejection fraction (RV-EF), cardiac output (RV-CO), and wall mass (RV-Mass) were measured with dedicated cardiac analysis software on 64-slice MDCT and compared with values measured with MRI in 43 consecutive patients with RMS. Agreement between MRI and 64-MDCT results were compared with Bland and Altman analysis and linear regression analysis. Repeated measurements were performed to determine intraobserver and interobserver variability.</p><p><b>RESULTS</b>No significant differences were revealed in calculated RV function parameters between the two methods. RV-EDV, RV-ESV, RV-SV, RV-EF, RV-CO, and RV-Mass by 64-slice MDCT were similar to those by MRI (P > 0.05). There were good correlations (r = 0.98, 0.97, 0.96, 0.96, 0.95 and 0.77, respectively) and close agreement (bias = -0.2 ml, -1.0 ml, 0.8 ml, 0.5%, 26.1 ml, and 0.5 g, respectively, P > 0.05). The variability in 64-slice MDCT measurements was similar to that in MRI values.</p><p><b>CONCLUSION</b>ECG-gated 64-slice MDCT could assess the RV function in RMS with high accuracy and reproducibility when compared to MRI.</p>