European journal of radiology · 2026
Clinical relevance and reproducibility of morphological MRI findings in liver cirrhosis: Results from ACCESS-ESLD.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Swerkersson Signe, Bartholomä Wolf, Forsgren Mikael F, Stjernman Henrik, Sjögren Daniel, Kechagias Stergios, Nasr Patrik, Holmberg Markus, Lundberg Peter, Rejler Martin, Leinhard Olof Dahlqvist, Dahlström Nils, Ekstedt Mattias
Аннотация
OBJECTIVES: To validate the clinical relevance and reproducibility of morphological features on magnetic resonance imaging (MRI) in liver cirrhosis.
MATERIALS & METHODS: This is a cross-sectional analysis of the baseline MRI examinations in a prospective multi-center study of patients with liver cirrhosis. Two radiologists independently assessed multiple morphological features and the overall degree of cirrhotic changes using a 5-point grading scale: 1 = none, 2 = subtle, 3 = moderate, 4 = evident, 5 = severe. Logistic regression was used to determine the association between imaging findings and clinical severity, using the model for end-stage liver disease (MELD) and Child-Pugh as reference standards. Inter- and intrareader agreement was assessed to evaluate reproducibility.
RESULTS: In our cohort of 150 patients (mean age, 64 ± 11 years, 43% women; 90% Child Pugh A) evident to severe cirrhotic changes on imaging were associated with MELD ≥ 10 and a Child-Pugh >5, odds ratios (OR) of 3.16 (95% confidence interval (CI): 1.54, 7.41, p = 0.008) and 4.15 (95% CI: 1.79, 9.63, p < 0.001) respectively. Reader agreement was substantial (κ = 0.59-0.64). Non-gastroesophageal portosystemic collaterals also demonstrated strong associations with clinical severity and consistent agreement between readers.
CONCLUSION: Morphological MRI features in liver cirrhosis are associated with established clinical markers of disease severity and demonstrate reasonable reproducibility, supporting their potential role in non-invasive disease assessment.
MATERIALS & METHODS: This is a cross-sectional analysis of the baseline MRI examinations in a prospective multi-center study of patients with liver cirrhosis. Two radiologists independently assessed multiple morphological features and the overall degree of cirrhotic changes using a 5-point grading scale: 1 = none, 2 = subtle, 3 = moderate, 4 = evident, 5 = severe. Logistic regression was used to determine the association between imaging findings and clinical severity, using the model for end-stage liver disease (MELD) and Child-Pugh as reference standards. Inter- and intrareader agreement was assessed to evaluate reproducibility.
RESULTS: In our cohort of 150 patients (mean age, 64 ± 11 years, 43% women; 90% Child Pugh A) evident to severe cirrhotic changes on imaging were associated with MELD ≥ 10 and a Child-Pugh >5, odds ratios (OR) of 3.16 (95% confidence interval (CI): 1.54, 7.41, p = 0.008) and 4.15 (95% CI: 1.79, 9.63, p < 0.001) respectively. Reader agreement was substantial (κ = 0.59-0.64). Non-gastroesophageal portosystemic collaterals also demonstrated strong associations with clinical severity and consistent agreement between readers.
CONCLUSION: Morphological MRI features in liver cirrhosis are associated with established clinical markers of disease severity and demonstrate reasonable reproducibility, supporting their potential role in non-invasive disease assessment.