Fig 1.
Flowchart of patient inclusion.
The criteria for inclusion in this study were Gd-EOB-DTPA-enhanced MRI of the liver as well as evaluation of histopathological liver samples concerning fibrotic and inflammation findings (within three months of the examination) from a patient cohort analyzed in 2015.
Table 1.
Baseline characteristics of the included patient cohort.
Fig 2.
The level of inflammation plotted against the level of fibrosis/cirrhosis.
The figure shows the level of inflammation, as characterized by the histologic activity index (mHAI) in comparison to the Ishak-Score. A dash indicates the mean of each group in the data cloud.
Table 2.
Hepatic fibrosis in correlation to hepatic inflammation.
Table 3.
Ishak-Score as histologic fibrosis index based on Ishak [14].
Table 4.
Modified histologic activity index (mHAI) based on Ishak [14].
Fig 3.
Representative images of a case with (A) high hepatic enhancement (RE: 1.29), absent inflammation (mHAI 0) and no fibrotic marker (ISHAK 0) is shown in comparison to a case with (B) low hepatic enhancement (RE: 0.30) paired with active inflammation (mHAI 9) and fibrosis (ISHAK 4). The first column represents the non-contrasted MR image while the second column represents the hepatobiliary phase. The corresponding histopathological imaging of the evaluated hepatic sections is shown in the third column. All displayed MR images have the same window and center level. The scale bar on histopathological images represents 500 μm.
Fig 4.
Relative enhancement (RE) values plotted with corresponding mHAI (A) and Ishak-Score (B) separately and combined (C). A dash indicates the mean of each group in the data cloud. Each dot represents the median of the combined model in graph C. The corresponding correlations with RE as the dependent variable are as followed: mHAI, r2 = 0.142, p = < 0.001; Ishak-Score, r2 = 0.792, p < 0.001. The combined model accounts for an R2 of 0.815.
Table 5.
Simple linear regression models of SI-based indices with HFI and modified HAI.
Table 6.
Simple linear regression models of SI-based indices with modified HAI and specific criteria of modified HAI (mHAI).
Table 7.
Multiple linear regression analysis with the relative signal change (RE) as a dependent variable.
The model showed a coefficient of determination (R2) of 0.815.
Fig 5.
Relative enhancement (RE) values plotted against the combined model for patients with unknown/non-parenchymal disease (A), known inflammatory- (B), and non-inflammatory-parenchymal diseases (C). Each dot represents the median of the combined model. The corresponding correlations with RE as the dependent variable are as followed: A, R2 = 0.503; B, R2 = 0.849: C, R2 = 0.812.
Table 8.
Enhancement values for patients with known parenchymal and tumor diseases and their corresponding mHAI (Modified histologic activity index) and Ishak-Scores.
Fig 6.
Relative enhancement (RE) values plotted against the combined model for patients with non-tumorous (A), benign tumorous (B), and malignant tumorous diseases (C). Each dot represents the median of the combined model. The corresponding correlations with RE as the dependent variable are as followed: A, R2 = 0.852; B, no significant correlation: C, R2 = 0.751. mHAI, histologic activity index.