SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Intermédiaire
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Docteur Jean-Louis PAYEN
Coup de coeur :
 
 
Journal of Hepatology
  2018/11  
 
  2018 Nov;69(5):1015-1024.  
  doi: 10.1016/j.jhep.2018.05.037  
 
  Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging  
 
  Bradley CR, Cox EF, Scott RA, James MW, Kaye P, Aithal GP, Francis ST, Guha IN  
  https://www.ncbi.nlm.nih.gov/pubmed/29886155  
 
 

Abstract

BACKGROUND & AIMS:

Advancing liver disease results in deleterious changes in a number of critical organs. The ability to measure structure, blood flow and tissue perfusion within multiple organs in a single scan has implications for determining the balance of benefit vs. harm for therapies. Our aim was to establish the feasibility of magnetic resonance imaging (MRI) to assess changes in Compensated Cirrhosis (CC), and relate this to disease severity and future liver-related outcomes (LROs).

METHODS:

A total of 60 patients with CC, 40 healthy volunteers and 7 patients with decompensated cirrhosis were recruited. In a single scan session, MRI measures comprised phase-contrast MRI vessel blood flow, arterial spin labelling tissue perfusion, T1 longitudinal relaxation time, heart rate, cardiac index, and volume assessment of the liver, spleen and kidneys. We explored the association between MRI parameters and disease severity, analysing differences in baseline MRI parameters in the 11 (18%) patients with CC who experienced future LROs.

RESULTS:

In the liver, compositional changes were reflected by increased T1 in progressive disease (p <0.001) and an increase in liver volume in CC (p = 0.006), with associated progressive reduction in liver (p <0.001) and splenic (p <0.001) perfusion. A significant reduction in renal cortex T1 and increase in cardiac index and superior mesenteric arterial blood flow was seen with increasing disease severity. Baseline liver T1 (p = 0.01), liver perfusion (p <0.01), and renal cortex T1 (p <0.01) were significantly different in patients with CC who subsequently developed negative LROs.

CONCLUSIONS:

MRI enables the contemporaneous assessment of organs in liver cirrhosis in a single scan without the requirement for a contrast agent. MRI parameters of liver T1, renal T1, hepatic and splenic perfusion, and superior mesenteric arterial blood flow were related to the risk of LROs.

LAY SUMMARY:

This study assesses the changes to structure, blood flow and perfusion that occur in the key organs (liver, spleen and kidney) associated with severe liver disease (Compensated Cirrhosis), using magnetic resonance imaging. The magnetic resonance imaging measures which changed with disease severity and were related to negative liver-related clinical outcomes are described.

 

 
Question posée
 
Évaluation multi-organes de patients atteints de cirrhose compensée par IRM.
 
Question posée
 
L'IRM permet l'évaluation simultanée des organes de la cirrhose du foie en un seul balayage sans recourir à un agent de contraste. Les paramètres IRM du foie, du rein, du débit de perfusion hépatique, splénique et du débit sanguin artériel mésentérique supérieur étaient associés à la gravité de l’hépatopathie.
 
Commentaires

Probablement un outil non invasif d’avenir dans l’évaluation pronostic de la maladie du foie, à suivre …

 
www.snfge.org