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Feasibility of In Vivo MR Elastographic Splenic Stiffness Measurements in the Assessment of Portal Hypertension

¹ Advanced Liver Diseases Study Group, Department of Gastroenterology and Hepatology, Miles and Shirley Fiterman Center for Digestive Diseases, Mayo Clinic, Rochester, MN.
² Center for Advanced Imaging Research, Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.
³ Present address: Department of Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁴ Naval Research Laboratory, Washington, DC.

View larger version (17K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Diagram shows system for application of shear waves to abdomen for MR elastography of liver. Acoustic pressure waves (60 Hz) are generated by active audio driver located away from magnetic field of MRI unit and transmitted through flexible tube to passive pneumatic driver placed over anterior body wall. Inset shows left coronal view of location of passive pneumatic driver (circle) with respect to liver. (Adapted with permission from [14])

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images show anatomic findings.

View larger version (49K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images with superimposed wave image data in liver and spleen show that shear wavelength for both liver and spleen is higher in patients with cirrhosis (E and H) than in healthy volunteer (B).

View larger version (49K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR elastograms show that mean spleen stiffness of fibrotic livers (F and I) is much higher than that of normal liver (C) (11.5 ± 1.1 kPa and 19.6 ± 3.3 kPa vs 3.6 ± 0.4 kPa). Mean liver stiffness is also higher in patients with cirrhosis (8.3 ± 1.5 kPa and 18.9 ± 2.9 kPa) than in healthy volunteer (2.1 ± 0.3 kPa).

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images show anatomic findings.

View larger version (62K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images with superimposed wave image data in liver and spleen show that shear wavelength for both liver and spleen is higher in patients with cirrhosis (E and H) than in healthy volunteer (B).

View larger version (66K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2F —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR elastograms show that mean spleen stiffness of fibrotic livers (F and I) is much higher than that of normal liver (C) (11.5 ± 1.1 kPa and 19.6 ± 3.3 kPa vs 3.6 ± 0.4 kPa). Mean liver stiffness is also higher in patients with cirrhosis (8.3 ± 1.5 kPa and 18.9 ± 2.9 kPa) than in healthy volunteer (2.1 ± 0.3 kPa).

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2G —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images show anatomic findings.

View larger version (62K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2H —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR images with superimposed wave image data in liver and spleen show that shear wavelength for both liver and spleen is higher in patients with cirrhosis (E and H) than in healthy volunteer (B).

View larger version (64K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2I —28-year-old healthy volunteer (A-C) and 46-year-old patient (D-F) and 54-year-old patient (G-I) with cirrhosis. MR elastograms show that mean spleen stiffness of fibrotic livers (F and I) is much higher than that of normal liver (C) (11.5 ± 1.1 kPa and 19.6 ± 3.3 kPa vs 3.6 ± 0.4 kPa). Mean liver stiffness is also higher in patients with cirrhosis (8.3 ± 1.5 kPa and 18.9 ± 2.9 kPa) than in healthy volunteer (2.1 ± 0.3 kPa).

View larger version (15K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —Graph shows good correlation between mean liver and mean spleen stiffness values among healthy volunteers and patients with varying stages of chronic liver disease (r2 = 0.75; p < 0.001).

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