A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
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Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the disease. Despite the good progress made with the liver stiffness map (LSM) based on magnetic resonance elastography (MRE), there are still some limitations that need to be overcome, including manual focus determination, manual selection of regions of interest (ROIs), and discontinuous LSM data without structural information, which makes it impossible to evaluate the liver as a whole. In this study, we propose a novel three-dimensional (3D) digital model for the early diagnosis of hepatic fibrosis based on MRE. MRE is a non-invasive imaging technique that employs magnetic resonance imaging (MRI) to measure the liver stiffness at the scanning site through human-computer interaction. Studies have indicated a significant positive correlation between the LSM obtained through MRE and the degree of hepatic fibrosis. However, for clinical purposes, a comprehensive and precise quantification of the degree of hepatic fibrosis is necessary. To address this, the concept of Liver Stiffness Distribution (LSD) was proposed in this study, which refers to the 3D stiffness volume of each liver voxel obtained by the alignment of 3D liver tissue images and MRE indicators. This provides a more effective clinical tool for the diagnosis and treatment of hepatic fibrosis.Keywords:
Magnetic Resonance Elastography
Hepatic fibrosis
Liver disease
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Elastography or elasticity imaging can be defined as the science and methodology of estimating the mechanical properties of a medium (including soft tissue). Elastography methods generally use an external source of force to produce a static or dynamic stress distribution on the probed medium. The applied stress causes a displacement distribution within the medium, which can be measured or imaged by ultrasound, magnetic resonance, or optical methods. In this paper, the relation of elastography to tissue pathology will be described and an overview of a number of recent patents will be provided. The most representative patents on both static and dynamic elastography methods will be presented, and emphasis will be given on the dynamic-based methods and devices that rely on the acoustic radiation force of ultrasound. A short reference will be also provided to patents on magnetic resonance elastography. Keywords: Acoustic radiation force, elasticity imaging, dynamic elastography, magnetic resonance elastography, shear waves, static elastography, viscoelastic media
Magnetic Resonance Elastography
Acoustic Radiation Force
Elasticity
Ultrasound Elastography
Shear waves
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The mechanical properties of soft tissues are closely associated with a variety of diseases. This motivates the development of elastography techniques in which tissue mechanical properties are quantitatively estimated through imaging. Magnetic resonance elastography (MRE) is a noninvasive phase-contrast MR technique wherein shear modulus of soft tissue can be spatially and temporally estimated. MRE has recently received significant attention due to its capability in noninvasively estimating tissue mechanical properties, which can offer considerable diagnostic potential. In this work, recent technology advances of MRE, its future clinical applications, and the related limitations will be discussed.
Magnetic Resonance Elastography
Shear modulus
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Magnetic resonance elastography can be used to measure the elastic stress of the liver and the extent of hepatic fibrosis quantitatively.This paper describes the principles and practical implementation of magnetic resonance elastography,including tissue biomechanical model analysis,development of the shear wave developing stimulator,design of elastic imaging sequence and fitting algorithms for elastography.Magnetic resonance elastography measurements on ex vivo pork liver and human volunteers were demonstrated experimentally.
Magnetic Resonance Elastography
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Background: Magnetic resonance elastography (MRE) is a non-invasive test used to assess liver stiffness and fibrosis in chronic liver disease, which includes systemic iron overload. However, iron deposition by itself is associated with technical failure of MRE of the liver which necessitates the use of invasive liver biopsy as an alternative monitoring method for these patients. T2*-weighted magnetic resonance imaging (T2*) is a reliable modality to asses for hepatic as well as total body iron overload. Therefore, we aimed to determine a cutoff value on the T2* reading at which MRE would no longer provide accurate stiffness measurements in patients with iron overload. Methods: Ninety-five patients with iron overload who underwent MRE at our institution, between 2010 and 2017 were reviewed retrospectively. We compared T2* values between patients with adequate elastography (N=63) versus those with non-diagnostic elastography (N=32). We additionally examined the ability of T2* to predict the likelihood of non-diagnostic elastography by estimating area under the ROC curve (AUC). Results: T2* was significantly different between patients with and without an adequate elastography (P<0.0001) and predicted occurrence of non-diagnostic elastography with an AUC of 0.95. All patients with a non-diagnostic elastography had a T2* value below 20 milliseconds (ms), and correspondingly 55% of the patients with a T2* value below 20 ms had a non-diagnostic elastography. The subgroups of patients with a T2* value ≤10, ≤8, and ≤6 ms, had a higher likelihood of non-diagnostic elastography (87%, 92%, and 95%, respectively). Conclusions: T2* can be used to accurately predict which patients are most likely to have a non-diagnostic elastography reading. T2* of 20 ms or lower reflects a higher likelihood of non-diagnostic elastography.
Magnetic Resonance Elastography
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The development of hepatic fibrosis is the hallmark of liver disease progression. Identifying fibrosis across the spectrum, from early stages to cirrhosis has become a major unmet need. Newer imaging techniques that measure liver elastography (stiffness) as a surrogate of fibrosis seem to outperform serum tests. The current study compares two-dimensional (2D) gradient-recalled echo magnetic resonance elastography (MRE) to three-dimensional (3D) spin-echo echo-planar imaging MRE. 3D-SE-EPI MRE was able to image more liver volume in less time with fewer technical failures. The current study demonstrates that 3D-SE-EPI MRE appears marginally superior to 2D-GRE and may evolve into the new gold standard.
Magnetic Resonance Elastography
Transient elastography
Gold standard (test)
Chronic liver disease
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For diagnosis of fibrosis we developed an ultrasound elastography system .which combines the advantages of magnetic resonance elastography (MRE) with ultrasound elastography (USE). Multi-frequency MRE has a high diagnostic power for the staging of low grades of fibrosis. USE has the potential to provide similar results in real-time and at low costs with a wide availability. We demonstrate the feasibility of time-harmonic multi-frequency USE at six volunteers and compare the resulting shear wave speed dispersion over seven frequencies with literature values from MRE.
Magnetic Resonance Elastography
Harmonic
Ultrasound Elastography
Transient elastography
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Magnetic Resonance Elastography
Palpation
Elasticity
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Magnetic Resonance Elastography
Palpation
Neuroradiology
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Hepatic fibrosis caused by chronic liver disease with different pathogenesis commonly progresses to liver cirrhosis.As the invasive diagnosis has limitations in clinical practice,the non-invasive method is essential for the assessment of hepatic fibrosis and monitoring of the progress of the disease.The elastography has been considered as an effective method in evaluating hepatic fibrosis.The recently developed magnetic resonance elastography has good application prospect in assessing hepatic fibrosis.This article reviewed the application of magnetic resonance elastography in the diagnosis of hepatic fibrosis.
Magnetic Resonance Elastography
Hepatic fibrosis
Chronic liver disease
Transient elastography
Pathogenesis
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Introduction: Magnetic resonance elastography (MRE) is an MRI-based modality that analyzes the movement of shear waves thorough tissue to determine stiffness, offering a way to "palpate" with imaging. A prior study on meningiomas showed prospective MRE measurements correlated well with surgeons' intraoperative observations regarding tumor consistency. However, this study reported the overall tumor consistency based on a lower resolution MRE technique and did not detect intratumoral differences. The purpose of our study was to evaluate a higher-resolution MRE technique to investigate whether intratumoral variations in softness or hardness could be detected with MRE.
Magnetic Resonance Elastography
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