Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case-control study

Eur Radiol. 2013 Jan;23(1):156-62. doi: 10.1007/s00330-012-2571-6. Epub 2012 Jul 20.


Objective: To examine if liver stiffness measured by magnetic resonance elastography (MRE) is a risk factor for hepatocellular carcinoma (HCC) in patients with chronic liver disease.

Methods: By reviewing the records of magnetic resonance (MR) examinations performed at our institution, we selected 301 patients with chronic liver disease who did not have a previous medical history of HCC. All patients underwent MRE and gadoxetic acid-enhanced MR imaging. HCC was identified on MR images in 66 of the 301 patients, who were matched to controls from the remaining patients without HCC according to age. MRE images were obtained by visualising elastic waves generated in the liver by pneumatic vibration transferred via a cylindrical passive driver. Risk factors of HCC development were determined by the odds ratio with logistic regression analysis; gender and liver stiffness by MRE and serum levels of aspartate transferase, alanine transferase, alpha-fetoprotein, and protein induced by vitamin K absence-II.

Results: Multivariate analysis revealed that only liver stiffness by MRE was a significant risk factor for HCC with an odds ratio (95 % confidence interval) of 1.38 (1.05-1.84).

Conclusion: Liver stiffness measured by MRE is an independent risk factor for HCC in patients with chronic liver disease.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology*
  • Case-Control Studies
  • Chi-Square Distribution
  • Chronic Disease
  • Contrast Media
  • Elasticity Imaging Techniques / methods*
  • Female
  • Gadolinium DTPA
  • Humans
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / pathology
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology*
  • Logistic Models
  • Male
  • Retrospective Studies
  • Risk Factors
  • Statistics, Nonparametric


  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA