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Background <p>Establishing an early and accurate diagnostic approach for identifying decompensation in cirrhosis patients is essential. This study compares the diagnostic value of liver shear stiffness (LSS) measurements from magnetic resonance elastography (MRE) with relative liver enhancement (RLE) measurements from hepatobiliary phase images of gadoxetic acid-enhanced MRI in patients with decompensated cirrhosis.</p> Methods <p>We prospectively enrolled 79 cirrhotic patients who underwent gadoxetic acid-enhanced MRI and MRE, dividing them into two groups: compensated cirrhosis (<i>n</i> = 35) and decompensated cirrhosis (<i>n</i> = 44). Spearman’s rank correlation analysis was used to evaluate the correlation of the LSS and RLE with the Child-Pugh scoring system and the Model for End-Stage Liver Disease (MELD) scoring system in cirrhotic patients. Receiver operating characteristic (ROC) analysis assessed the diagnostic performance of LSS in detecting decompensated cirrhosis, comparing it with RLE. The diagnostic performance of the combined parameters of LSS and RLE was also assessed. Multivariate logistic regression identified factors associated with decompensation.</p> Results <p>Spearman’s rank correlation analysis identified that LSS and RLE were both significantly correlated with Child-Pugh and MELD scores (all p values &lt; 0.001). LSS demonstrated significantly higher diagnostic performance than RLE for identifying decompensated cirrhosis (area under the ROC curve [AUROC]: 0.90 [95% CI: 0.83–0.97] vs. 0.77 [95% CI: 0.66–0.87], <i>p</i> = 0.015). However, adding RLE to LSS did not significantly improve diagnostic performance (AUROC: 0.90 [95% CI: 0.83–0.97], <i>p</i> = 0.947). The optimal LSS threshold for distinguishing between compensated and decompensated cirrhosis was 4.57&#xa0;kPa. LSS was identified as an independent risk factor for decompensated cirrhosis, both unadjusted and after controlling for albumin levels, platelet count, AST, and RLE (OR = 4.31, 95% CI: 1.78–10.41).</p> Conclusion <p>LSS measured by MRE is an independent risk factor for decompensated cirrhosis and demonstrates superior diagnostic performance compared to RLE. Additionally, compared to MRE alone, there is no significant improvement in diagnostic accuracy for decompensated cirrhosis when combining RLE.</p>

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The diagnostic value of MRE in patients with decompensated cirrhosis: comparing it to Gd-EOB-DTPA–enhanced MRI

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Mengjiao Duan,
  • Ziqing Sun,
  • Qiqi Chu,
  • Mengyue Huang,
  • Feifei Yao,
  • Yingyu Che,
  • Yong Zhang,
  • Kaiyu Wang,
  • Jingjing Liu

摘要

Background

Establishing an early and accurate diagnostic approach for identifying decompensation in cirrhosis patients is essential. This study compares the diagnostic value of liver shear stiffness (LSS) measurements from magnetic resonance elastography (MRE) with relative liver enhancement (RLE) measurements from hepatobiliary phase images of gadoxetic acid-enhanced MRI in patients with decompensated cirrhosis.

Methods

We prospectively enrolled 79 cirrhotic patients who underwent gadoxetic acid-enhanced MRI and MRE, dividing them into two groups: compensated cirrhosis (n = 35) and decompensated cirrhosis (n = 44). Spearman’s rank correlation analysis was used to evaluate the correlation of the LSS and RLE with the Child-Pugh scoring system and the Model for End-Stage Liver Disease (MELD) scoring system in cirrhotic patients. Receiver operating characteristic (ROC) analysis assessed the diagnostic performance of LSS in detecting decompensated cirrhosis, comparing it with RLE. The diagnostic performance of the combined parameters of LSS and RLE was also assessed. Multivariate logistic regression identified factors associated with decompensation.

Results

Spearman’s rank correlation analysis identified that LSS and RLE were both significantly correlated with Child-Pugh and MELD scores (all p values < 0.001). LSS demonstrated significantly higher diagnostic performance than RLE for identifying decompensated cirrhosis (area under the ROC curve [AUROC]: 0.90 [95% CI: 0.83–0.97] vs. 0.77 [95% CI: 0.66–0.87], p = 0.015). However, adding RLE to LSS did not significantly improve diagnostic performance (AUROC: 0.90 [95% CI: 0.83–0.97], p = 0.947). The optimal LSS threshold for distinguishing between compensated and decompensated cirrhosis was 4.57 kPa. LSS was identified as an independent risk factor for decompensated cirrhosis, both unadjusted and after controlling for albumin levels, platelet count, AST, and RLE (OR = 4.31, 95% CI: 1.78–10.41).

Conclusion

LSS measured by MRE is an independent risk factor for decompensated cirrhosis and demonstrates superior diagnostic performance compared to RLE. Additionally, compared to MRE alone, there is no significant improvement in diagnostic accuracy for decompensated cirrhosis when combining RLE.