Diagnostic accuracy of dual-echo (in- and opposed-phase) T1-weighted gradient recalled echo for detection and grading of hepatic iron using quantitative and visual assessment.
Objectives: Detection and quantification of hepatic iron with dual-echo gradient recalled echo (GRE) has been proposed as a rapid alternative to other magnetic resonance imaging (MRI) techniques. Co-existing steatosis and T1 weighting are limitations. This study assesses the accuracy of routine dual...
| Publicado en: | European Radiology Vol. 24; no. 7; pp. 1437 - 1446 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Jul2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103827362&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103827362 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jul2014 vid: 24 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103827362 NLM24788037 2012607284 10.1007/s00330-014-3170-5 NLM24788037 103827362 ppf: 1437 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Diagnostic accuracy of dual-echo (in- and opposed-phase) T1-weighted gradient recalled echo for detection and grading of hepatic iron using quantitative and visual assessment. aug: au: Schieda, Nicola Ramanathan, Subramaniyan Ryan, John Khanna, Maneesh Virmani, Vivek Avruch, Leonard affil: The Ottawa Hospital, The University of Ottawa, 1053 Carling Avenue; , Ottawa, Ontario, Canada, K1Y 4E9, nschieda@toh.on.ca. sug: subj: Magnetic Resonance Imaging Methods Fatty Liver Diagnosis Iron Analysis Iron Overload Diagnosis Liver Adolescence Adult Aged Aged, 80 and Over Fatty Liver Metabolism Female Prospective Studies Human Iron Overload Metabolism Liver Pathology Male Middle Age Reproducibility of Results Retrospective Design Young Adult Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Objectives: Detection and quantification of hepatic iron with dual-echo gradient recalled echo (GRE) has been proposed as a rapid alternative to other magnetic resonance imaging (MRI) techniques. Co-existing steatosis and T1 weighting are limitations. This study assesses the accuracy of routine dual-echo GRE.Methodology: Between 2010 and 2013, 109 consecutive patients underwent multi-echo (ME) MRI and dual-echo GRE for quantification of hepatic iron. Liver iron concentration (LIC) was calculated from ME-MRI. Relative signal intensity (RSI) and fat signal fraction (FSF) were calculated from dual-echo GRE. Four radiologists subjectively evaluated dual-echo GRE (±subtraction). Diagnostic accuracy was compared between techniques and correlated with biopsy using Fisher's exact test, Spearman correlation and regression.Results: The sensitivity of visual detection of iron ranged from 48 to 55%. Subtraction did not increase sensitivity (p < 0.001). Inter-observer variability was substantial (κ = 0.72). The specificity of visual detection of iron approached 100% with false-positive diagnoses observed using subtraction. LIC showed a higher correlation with histopathological iron grade (r = 0.94, p < 0.001) compared with RSI (r = 0.65, p = 0.02). Univariate regression showed an association between RSI and LIC (B = 0.98, p < 0.001, CI 0.73-1.23); however, the association was not significant with multi-variate regression including FSF (p = 0.28).Conclusions: Dual-echo GRE has low sensitivity for hepatic iron. Subtraction imaging can result in false-positive diagnoses.Key Points: • Routine liver MRI studies cannot effectively screen patients for iron overload. • Concomitant hepatic steatosis and iron limits diagnostic accuracy of routine liver MRI. • Dual-echo GRE subtraction imaging causes false-positive diagnoses of iron overload. • Dedicated MRI techniques should be used to diagnose and quantify iron overload. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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