Table 4.
Magnetic resonance elastography for prediction of varices
| Author, Journal, Year | Liver/Spleen | Patient N | Etiology | Cut-offs for EV (AUC) | EV: Sens/Spec/+LR/-LR/acc/p | Cut-offs for VNT (AUC) | VNT: Sens/Spec/+LR/-LR/acc/p | Prevalence of EV and VNT | Comment |
| Ronot et al. Eur Radiol 2014[63] | yes/yes | 36 | mixed | NR | NR | Gl, 84 Hz: 4.2 kPa (0.93) | 54%/100%/PPV: 33%/NPV: 79%/P = 0.001 | Any EV: 75%; VNT: 72% | Liver MRE not predictive of EV or VNT. Advantage of 3D multifrequency MRE |
| Sun et al. J Magn Reson Imaging 2014[62] | yes/no | 126 | mixed | L-MRE: 4.63 kPa (0.859) | NR | L-MRE: 5.803 kPa (0.810) | L-MRE: 96%/60%/n.r. | Any EV: 49%; VNT: 19% | Pearson correlation coefficient between liver stiffness and EV: 0.63 (P < 0.0001). |
| Shin et al. Radiology 2014[61] | yes/yes | 139 | mixed | L-MRE: 4.58 kPa (0.821) S-MRE: 7.23 kPa (0.833) | L-MRE: 87.4%/65.6%/n.r. S-MRE: 85.8%/65.4%/n.r. | L-MRE: 4.81 kPa (0.755) S-MRE: 7.60 kPa (0.750) | L-MRE: 84.4%/56.7%/n.r S-MRE: 68.3%/61.6%/n.r. | Any EV: 56%; VNT: 32% | Data cross-validated; several false-positive diagnoses of EV and VNT due to high liver stiffness and non-esophageal collaterals; 11 cases of false-negative diagnoses of EV: pre-hepatic PHT, iron deposition, large ascites. |
| Matsui, Journal of Gastroenterology and Hepatology, 2018[100] | yes/no | 627 | mixed | MRE: 4.2 kPa (0.85) PLT: 18*104 (0.77) | MRE: 85%/69%/PPV 32%/NPV 96% MRE + PLT: 93%/43%/PPV 22%/NPV 96% | MRE: 4.2 kPa (0.85) PLT: 18*104 (0.77) | MRE: 94%/65%/PPV 17%/ NPV 99% MRE + PLT: 100%/35%/PPV 10%/ NPV 100% | Any EV: 15.6% VNT: 4.5% | 3T device; also validated Baveno VI criteria (1) and modified Baveno VI criteria (30); excellent performance in NAFLD and viral hepatitis |
| Bookwalter, Abdominal Radiology, 2018[101] | yes/no | 55 | PSC | 6.27 kPa (NR) | Sens. 100%/Spec. 76.7% | NR | NR | NR | Several sequences, 2D and 3D modes, at 1,5T and 3T; Varices assessed by global LSM |
| Kim, European Radiologist, 2017[102] | yes/no | 84 | NR | GRE-MRE: (0.948) SE-EPI-MRE: (0.914) | NR | GRE-MRE: 4.493 kPa (0.752) SE-EPI-MRE: 5.880 kPa (0.839) | NR | Any EV: 17.9% VNT: 8.3% | Neither SE-EPI-, nor GRE-MRE reached significance regarding diagnostic performance |
AUC: Area under the (receiver operating) curve; CSPH: Clinically significant portal hypertension; LSM: Liver stiffness measurement; EV: Esophageal varices; MRE: Magnetic resonance elastography; TE: Transient elastography; Plt: Platelet count; VNT: Varices needing treatment; NR: Not reported; SSM: Spleen stiffness measurement; SE-EPI: Spin-echo echoplanar imaging; GRE: Gradient recalled echo.