Evaluation of quantitative MRCP (MRCP+) for risk stratification of primary sclerosing cholangitis: comparison with morphological MRCP, MR elastography, and biochemical risk scores.

Autor: Ismail MF; Toronto Centre for Liver Disease, University Health Network, University of Toronto, Institute of Health Policy Management and Evaluation, Toronto, ON, Canada., Hirschfield GM; Toronto Centre for Liver Disease, University Health Network, Mt. Sinai & WCH, University of Toronto, Institute of Health Policy Management and Evaluation, Toronto, ON, Canada., Hansen B; Toronto Centre for Liver Disease, University Health Network, University of Toronto, Institute of Health Policy Management and Evaluation, Toronto, ON, Canada., Tafur M; Joint Department of Medical Imaging, University Health Network, Mt. Sinai & WCH, University of Toronto, 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada.; St. Michael's Hospital, University of Toronto, Toronto, ON, Canada., Elbanna KY; Joint Department of Medical Imaging, University Health Network, Mt. Sinai & WCH, University of Toronto, 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada., Goldfinger MH; Perspectum Ltd, Oxford, UK., Ridgway GR; Perspectum Ltd, Oxford, UK., Jhaveri KS; Joint Department of Medical Imaging, University Health Network, Mt. Sinai & WCH, University of Toronto, 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada. Kartik.Jhaveri@uhn.ca.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2022 Jan; Vol. 32 (1), pp. 67-77. Date of Electronic Publication: 2021 Jul 06.
DOI: 10.1007/s00330-021-08142-y
Abstrakt: Objectives: To study the association of MRCP+ parameters with biochemical scoring systems and MR elastography (MRE) in primary sclerosing cholangitis (PSC). To evaluate the incremental value of combining MRCP+ with morphological scores in associating with biochemical scores.
Methods and Materials: MRI images, liver stiffness measurements by MRE, and biochemical testing of 65 patients with PSC that were retrospectively enrolled between January 2014 and December 2015 were obtained. MRCP+ was used to post-process MRCP images to obtain quantitative measurements of the bile ducts and biliary tree. Linear regression analysis was used to test the associations. Bootstrapping was used as a validation method.
Results: The total number of segmental strictures had the strongest association with Mayo Risk Score (R 2 = 0.14), minimum stricture diameter had the highest association with Amsterdam Oxford Prognostic Index (R 2 = 0.12), and the percentage of duct nodes with width 0-3 mm had the strongest association with PSC Risk Estimate Tool (R 2 = 0.09). The presence of Ducts with medians > 9 mm had the highest association with MRE (R 2 = 0.21). The strength of association of MRCP+ to Mayo Risk Score was similar to ANALI2 and weaker than MRE (R 2 = 0.23, 0.24, 0.38 respectively). MRCP+ enhanced the association of ANALI 2 and MRE with the Mayo Risk Score.
Conclusions: MRCP+ demonstrated a significant association with biochemical scores and MRE. The association of MRCP+ with the biochemical scores was generally comparable to ANALI scores. MRCP+ enhanced the association of ANALI2 and MRE with the Mayo Risk Score.
Key Points: • MRCP+ has the potential to act as a risk stratfier in PSC. • MRE outperformed MRCP+ for risk stratifcation. • Combination of MRCP+ with MRE and ANALI scores improved overall performace as risk stratifiers.
(© 2021. European Society of Radiology.)
Databáze: MEDLINE
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