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    Noncontrast-enhanced MRI-based noninvasive score for portal hypertension (CHESS1802): An international multicenter study
    (Xia & He Publishing Inc., 2021) Liu, Yanna; Tang, Tianyu; Örmeci, Necati; Huang, Yifei; Wang, Jitao; Li, Xiaoguo; Li, Zhiwei; An, Weimin; Liu, Dengxiang; Zhang, Chunqing; Liu, Changchun; Liu, Jinqiang; Liu, Chuan; Wang, Guangchuan; Mosconi, Cristina; Cappelli, Alberta; Bruno, Antonio; Akçalar, Seray; Çelebioğlu, Emrecan; Üstüner, Evren; Bilgiç, Sadık; Ellik, Zeynep; Asiller, Özgün Ömer
    Background and Aims This study aimed to determine the performance of the non-invasive score using noncontrast-enhanced MRI (CHESS-DIS score) for detecting portal hypertension in cirrhosis. Methods In this international multicenter, diagnostic study (ClinicalTrials.gov, NCT03766880), patients with cirrhosis who had hepatic venous pressure gradient (HVPG) measurement and noncontrast-enhanced MRI were prospectively recruited from four university hospitals in China (n=4) and Turkey (n=1) between December 2018 and April 2019. A cohort of patients was retrospectively recruited from a university hospital in Italy between March 2015 and November 2017. After segmentation of the liver on fat-suppressed T1-weighted MRI maps, CHESS-DIS score was calculated automatically by an in-house developed code based on the quantification of liver surface nodularity. Results A total of 149 patients were included, of which 124 were from four Chinese hospitals (training cohort) and 25 were from two international hospitals (validation cohort). A positive correlation between CHESS-DIS score and HVPG was found with the correlation coefficients of 0.36 (p<0.0001) and 0.55 (p<0.01) for the training and validation cohorts, respectively. The area under the receiver operating characteristic curve of CHESS-DIS score in detection of clinically significant portal hypertension (CSPH) was 0.81 and 0.9 in the training and validation cohorts, respectively. The intraclass correlation coefficients for assessing the inter- and intra-observer agreement were 0.846 and 0.841, respectively. Conclusions A non-invasive score using noncontrast-enhanced MRI was developed and proved to be significantly correlated with invasive HVPG. Besides, this score could be used to detect CSPH in patients with cirrhosis.