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J Gastroenterol Hepatol. 2019 Feb 13. doi: 10.1111/jgh.14629. [Epub ahead of print]

Non-invasive structure-function assessment of the liver by 2D time-harmonic elastography and the dynamic Liver MAximum capacity (LiMAx) test.

Author information

1
Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
2
Department of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
3
Department of Gastroenterology and Hepatology, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
4
Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Abstract

BACKGROUND AND AIM:

Accurate assessment of structural and functional characteristics of the liver could improve the diagnosis and the clinical management of patients with chronic liver diseases. However, the structure-function relationship in the progression of chronic liver disease remains elusive. The aim of this study is the combined measurement of liver function by the 13 C-methacetin Liver MAximum capacity (LiMAx) test and tissue-structure related stiffness by 2D time-harmonic elastography for the assessment of liver disease progression.

METHODS:

LiMAx test and time-harmonic elastography were applied, and the serological scores fibrosis 4 index and aspartate aminotransferase to platelet ratio index were calculated in patients with chronic liver diseases (n = 75) and healthy control subjects (n = 22). In 47 patients who underwent surgery, fibrosis was graded by histological examination of the resected liver tissue.

RESULTS:

LiMAx values correlated negatively with liver stiffness (r = -0.747), aminotransferase to platelet ratio index (r = -0.604), and fibrosis 4 (r = -0.573). Median (interquartile range) LiMAx values decreased with fibrosis progression from 395 μg/kg/h (371-460 μg/kg/h) in participants with no fibrosis to 173 μg/kg/h (126-309 μg/kg/h) in patients with severe fibrosis. Median liver stiffness increased progressively with the stage of fibrosis from no fibrosis (1.56 m/s [1.52-1.63 m/s]) to moderate fibrosis (1.60 m/s [1.54-1.67 m/s]) to severe fibrosis (1.85 m/s [1.76-1.92 m/s]).

CONCLUSION:

Our findings show that structural changes in the liver due to progressing liver diseases and reflected by increased tissue stiffness correlate with a functional decline of the organ as reflected by a decreased metabolic capacity of the liver.

KEYWORDS:

LiMAx; dynamic liver function test; liver fibrosis; liver stiffness; time-harmonic elastography; ultrasound elastography

PMID:
30756433
DOI:
10.1111/jgh.14629

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