PURPOSE To compare liver stiffness measurement (LSM) with magnetic resonance elastography (MRE) and liver and spleen volumetry for prediction of disease severity and hepatic decompensation in primary sclerosing cholangitis (PSC). METHODS This retrospective study was approved by the institutional review board. Magnetic resonance imaging (MRI) and MRE studies were reviewed, and mean LSM of entire liver, right lobe and left lobe, total liver, right lobe, left lobe, caudate lobe, and spleen volumes were calculated. Qualitative evaluation of lobar atrophy or hypertrophy and presence of macronodular regeneration (MNR) was recorded. Statistical analysis was performed to evaluate correlations between LSM, volumetry measurements, and Mayo risk score. Univariate and multivariate analyses were performed to predict hepatic decompensation. RESULTS A total of 266 patients with PSC were included in the study. Lobar stiffness measures were higher in the presence of relative lobe atrophy. Mean LSM was higher in the presence of MNR. Significant correlations were observed between mean LSM and volumetry measurements with a fair correlation between LSM and spleen volume (rs = 0.526, p < 0.0001). Among the measurements, the best correlation was observed between mean LSM and Mayo risk score (rs = 0.646, p < 0.0001). In the multivariate analyses, mean LSM and Mayo risk score were significantly associated with liver decompensation (hazard ratio, 1.18; 95%CI 1.02-1.36 and hazard ratio, 1.65; 95%CI 1.08-2.53, respectively). CONCLUSION LSM with MRE performs significantly better than liver and spleen volumes for prediction of both disease severity and hepatic decompensation.

中文翻译：

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肝硬度测量与MRE和肝脾量测定法比较以预测原发性硬化性胆管炎患者的疾病严重程度和肝代偿失调。

目的比较肝硬度测量（LSM）与磁共振弹性成像（MRE）以及肝脏和脾脏容量，以预测原发性硬化性胆管炎（PSC）的疾病严重程度和肝代偿失调。方法这项回顾性研究获得了机构审查委员会的批准。回顾了磁共振成像（MRI）和MRE研究，并计算了整个肝脏，右叶和左叶，总肝脏，右叶，左叶，尾状叶和脾脏体积的平均LSM。记录了大叶萎缩或肥大以及大结节再生（MNR）的定性评估。进行统计分析以评估LSM，容量测量和Mayo风险评分之间的相关性。进行单因素和多因素分析以预测肝代偿失调。结果本研究共纳入266例PSC患者。在存在相对肺叶萎缩的情况下，肺叶硬度的测量值较高。存在MNR时，平均LSM较高。在平均LSM和容积测量之间观察到显着的相关性，而LSM与脾脏体积之间的相关性很强（rs = 0.526，p <0.0001）。在这些测量中，观察到平均LSM与Mayo风险评分之间的最佳相关性（rs = 0.646，p <0.0001）。在多元分析中，平均LSM和Mayo风险评分与肝脏代偿失调显着相关（危险比1.18； 95％CI 1.02-1.36和危险比1.65； 95％CI 1.08-2.53）。结论MSM的LSM在预测疾病严重程度和肝代偿失调方面的表现明显优于肝脏和脾脏。