Hepatic MRE Examination Protocol

All of the included subjects had undergone hepatic MRE examinations. MRE was performed using either MRE hardware (GE Healthcare, Waukesha, WI, USA) with a 1.5-T imaging system or a 1.5-T whole-body magnetic resonance unit (Gyroscan Intera, Philips Medical Systems, Best, the Netherlands) with a four-element torso coil. The two-dimensional MRE protocols used were similar to those described in previous literature [20 (link),21 (link)]. The LS values of hepatic parenchyma were measured using MRE by drawing four regions of interest (ROIs) on the elastogram. ROIs were determined by the attending radiologists. All ROIs were drawn in areas indicated as having high confidence and good signal-to-noise ratio with stiffness outliers being excluded on the confidence map [22 (link)], and copied to corresponding positions on stiffness maps, providing LS values in kilopascals. After reconfirming the adequate placement of ROIs in the right liver lobe, LS values were calculated as the median value of multiple ROIs. The definition of NASH and advanced hepatic fibrosis were based on the MRE standard of 2.91–3.59 kPa and ≥3.60 kPa, respectively [17 (link),23 (link)].