Ayşe Erden

Elif Peker

Diagnostic and Interventional Radiology

Directory of Open Access Journals

478Diagn Interv Radiol 2017; 23:478© Turkish Society of Radiology 2017L E T T E R  TO  T H E  E D I TO RT1 mapping and magnetic resonance elastography: potential new techniques for quantification of parenchymal changes in hepatic amyloidosisElif PekerAyşe ErdenFrom the Department of Radiology (A.E.  ayse.erden@medicine.ankara.edu.tr), Ankara University School of Medicine, Ankara, Turkey.We read with interest the pictorial essay by Özcan et al. (1) enti-tled “Imaging for abdominal involvement in amyloidosis” in the re-cent issue of Diagnostic and Interventional Radiology. In this article, the authors provide both textual and visual portrayals of abdomi-nal amyloidosis, which is difficult to diagnose because of nonspe-cific imaging findings and frequent subclinical presentation.Both computed tomography and magnetic resonance imaging (MRI) findings, in combination with clinical history, anatomic loca-tion and patient’s primary disease can help to limit the differential diagnosis. In this context, we would like to share our experience with two newly emerging imaging techniques that could be of interest to radiologists. A 46-year-old woman with biopsy-proven liver amyloidosis underwent liver and heart MRI examination with T1 mapping. Using modified look-locker inversion recovery (MOL-LI) sequence, liver T1 values were higher (855 ms at MOLLI 5(3)3(3) and 880 ms at MOLLI 3(3)3(3)5) compared with the mean values (550±70 ms at MOLLI 5(3)3(3) and 615±35 ms at MOLLI 3(3)3(3)5) obtained in healthy volunteers (Fig. a). Many studies proved that T1-mapping values are informative for the presence of myocardial amyloidosis and normal T1 values can exclude cardiac amyloidosis (2, 3). Although we have found hepatic T1 values more than 4 times the standard deviation in our case, further investigations are need-ed to confirm our observations regarding the utility of mapping techniques in liver amyloidosis.The patient was also evaluated with magnetic resonance elas-tography (MRE) during liver MRI and very high liver shear stiffness values (mean, 8.5 kPa) were detected (Fig. b, c). A recent report has documented increased liver stiffness measured by MRE in liver am-yloidosis (4). T1 mapping and MRE may be new tools to visualize and quantify liver changes in amyloidosis.Conflict of interest disclosureThe authors declared no conflicts of interest.References1. Özcan HN, Haliloğlu M, Sökmensüer C, Akata D, Özmen M, Karçaaltıncaba M. Imaging for abdominal involvement in amyloidosis. Diagn Interv Radiol 2017; 23:282–285. [CrossRef]2. Krombach GA, Hahn C, Tomars M, et al. Cardiac amyloidosis: MR imaging findings and T1 quantification, comparison with control subjects. J Magn Reson Imaging 2007; 25:1283–1287. [CrossRef]3. Karamitsos TD, Piechnik SK, Banypersad SM, et al. Noncontrast T1 mapping for the diagnosis of cardiac amyloidosis. JACC Cardiovasc Imaging 2013; 6:489–497. [CrossRef]4. Srinivasan S, Tan YQ, The HS, et al. Primary hepatic amyloidosis presenting as nodular masses on the background of diffuse infiltration and extreme liver stiffness on MR elastography. J Gastrointestin Liver Dis 2014; 23:437–440.Received 12 June 2017; accepted 27 June 2017.DOI 10.5152/dir.2017.17240You may cite this article as: Peker E, Erden A. T1 mapping and magnetic resonance elastography:  potential new techniques for quantification of parenchymal changes in hepatic amyloidosis. Diagn Interv Radiol 2017; 23:478.Figure. a–c. A 46-year-old woman with biopsy-proven liver amyloidosis. Unenhanced modified look-locker inversion recovery (MOLLI) T1 map at 1.5 T (a) reveal diffuse abnormal high T1 values. Wave image (b) and elastogram (c) reveal high liver shear stiffness values (mean 8.5 kPa).a b c

T1 mapping and magnetic resonance elastography: potential new techniques for quantification of parenchymal changes in hepatic amyloidosis

http://cms.dirjournal.org/Uploads/Article_55231/Diagn Interv Radiol-23-478-En.pdf

T1 mapping and magnetic resonance elastography: potential new techniques for quantification of parenchymal changes in hepatic amyloidosis

Abstract

Similar works

Full text

Available Versions

Directory of Open Access Journals