T2 Values for Diagnosing Acute-on-Chronic Liver Failure in Hepatitis B Patients

Objectives: The aim of this study was to investigate the value of hepatic T2 imaging for the evaluation of chronic hepatitis-B-related acute-on-chronic liver failure (HBV-ACLF). Methods: Three groups of patients underwent liver MRI utilising m-GRASE sequence (multi-echo gradient and spin echo): HBV-ACLF patients (n = 28), chronic hepatitis B patients (n = 11), and healthy control patients (n = 14). A T2 image was produced using post-processing software, and the mean T2 (relaxation time) value was calculated. Blood biochemical indices for the HBV-ACLF and Chronic Hepatitis B were obtained within 2 days pre- or post-MR scanning. The patients’ T2 values, and the correlation between their biochemical indices and T2 values were analysed. A receiver operating characteristic curve was employed to evaluate the efficiency of utilising T2 values in the diagnosis of HBV-ACLF. Results: There were significant variations in the T2 values (χ² = 19.074, P < 0.001) among the 3 groups. The AUC of T2 values for diagnosing HBV-ACLF was 0.86 (P < 0.001), with a cut-off value of 57.73 ms. A moderately positive correlation was observed between the T2 value and the international normalised ratio, prothrombin time, and hyaluronic acid values (rs = 0.65, P < 0.001; rs = 0.67, P < 0.001; rs = 0.39, P = 0.025). A moderately negative correlation was observed between the T2 value and the prothrombin activity, albumin, and prealbumin values (rs = -0.67, P < 0.001; rs = -0.48, P = 0.004; rs = -0.37, P = 0.030). Conclusion: T2 values could accurately reflect liver function state, as they correlated well with certain biochemical indices, illustrating good diagnostic efficiency for diagnosing HBV-ACLF.