Prognostic value of multiparametric magnetic resonance imaging, transient elastography and blood-based fibrosis markers in patients with chronic liver disease.
Liver Int
; 40(12): 3071-3082, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32730664
ABSTRACT
BACKGROUND & AIMS:
Liver cT1 , liver T1 , transient elastography (TE) and blood-based biomarkers have independently been shown to predict clinical outcomes but have not been directly compared in a single cohort of patients. Our aim was to compare these tests' prognostic value in a cohort of patients with compensated chronic liver disease.METHODS:
Patients with unselected compensated liver disease aetiologies had baseline assessments and were followed up for development of clinical outcomes, blinded to the imaging results. The prognostic value of non-invasive liver tests at prespecified thresholds was assessed for a combined clinical endpoint comprising ascites, variceal bleeding, hepatic encephalopathy, hepatocellular carcinoma, liver transplantation and mortality.RESULTS:
One hundred and ninety-seven patients (61% male) with median age of 54 years were followed up for 693 patient-years (median (IQR) 43 (26-58) months). The main diagnoses were NAFLD (41%), viral hepatitis (VH, 25%) and alcohol-related liver disease (ArLD; 14%). During follow-up 14 new clinical events, and 11 deaths occurred. Clinical outcomes were predicted by liver cT1 > 825ms with HR 9.9 (95% CI 1.29-76.4, P = .007), TE > 8kPa with HR 7.8 (95% CI 0.97-62.3, P = .02) and FIB-4 > 1.45 with HR 4.09 (95% CI 0.90-18.4, P = .05). In analysis taking into account technical failure and unreliability, liver cT1 > 825 ms could predict clinical outcomes (P = .03), but TE > 8kPa could not (P = .4).CONCLUSIONS:
We provide further evidence that liver cT1 , TE and serum-based biomarkers can predict clinical outcomes, but when taking into account technical failure/unreliability, TE cut-offs perform worse than those of cT1 and blood biomarkers.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Várices Esofágicas y Gástricas
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Diagnóstico por Imagen de Elasticidad
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Imágenes de Resonancia Magnética Multiparamétrica
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Neoplasias Hepáticas
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Límite:
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Liver Int
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido