Diagnostic accuracy of intracellular uptake rates calculated using dynamic Gd-EOB-DTPA-enhanced MRI for hepatic fibrosis stage.
Diagnostic accuracy of intracellular uptake rates calculated using dynamic Gd-EOB-DTPA-enhanced MRI for hepatic fibrosis stage.
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DOI：
10.1002/jmri.25431
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发表时间：
2017-04
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影响因子：
--
通讯作者：
Dyke JP
中科院分区：
文献类型：
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作者：
Juluru K;Talal AH;Yantiss RK;Spincemaille P;Weidman EK;Giambrone AE;Jalili S;Sourbron SP;Dyke JP
评估肝纤维化分期的细胞内摄取率（Ki）和其他定量药代动力学（PK）参数的诊断准确性;将该准确性与先前发表的半定量指标对比增强指数（CEI）进行比较;并评估肝脏区域之间这些参数的变异性。病例对照研究设计。动态Gd-EOB-DTPA增强的1.5T MRI前瞻性地在22名具有不同已知阶段的肝纤维化的受试者中进行。PK参数和CEI来自所有受试者的整个肝脏和三个固定的感兴趣区域（ROI）。计算斯皮尔曼等级相关系数，以评估纤维化分期与每个参数之间的关系。构建ROC曲线以区分严重纤维化（3-4期）与非严重纤维化（0-2期）。计算变异系数（CV）以评估ROI之间参数的变异性。Ki与纤维化分期显著相关（R=-0.55，95%CI [-0.79，-0.14]，p=0.01）。区分重度和非重度纤维化的Ki和CEI的ROC曲线下面积（AUC）分别为0.84（95% CI [0.65，1.00]）和0.64（95% CI [0.39，0.89]）（p=0.0248）。Ki和CEI的CV分别为33.4和5.8。PK模型中与纤维化分期具有显著相关性的唯一其他参数是绝对动脉血流量（Fa）（R=-0.48，95% CI [-0.75，-0.05]，p=0.03）。肝细胞内摄取率，Ki，来自DCE-MRI，与纤维化阶段相关，并可能有助于肝纤维化的非侵入性生物标志物。
To assess the diagnostic accuracy of intracellular uptake rates (Ki), and other quantitative pharmacokinetic (PK) parameters, for hepatic fibrosis stage; to compare this accuracy with a previously published semi-quantitative metric, contrast enhancement index (CEI); and to assess variability of these parameters between liver regions. Case-control study design. Dynamic Gd-EOB-DTPA-enhanced 1.5T MRI was performed prospectively in 22 subjects with varying known stages of hepatic fibrosis. PK parameters and CEI were derived from the whole livers and from three fixed regions of interest (ROI) in all subjects. Spearman rank correlation coefficients were computed to assess the relationship between fibrosis stages and each parameter. ROC curves were constructed to discriminate severe fibrosis (stages 3-4) from non-severe fibrosis (stages 0-2). Coefficient of variation (CV) was calculated to assess variability in parameters between ROIs. Ki and fibrosis stage were significantly correlated (R=-0.55, 95% CI [-0.79, -0.14], p=0.01). Area under ROC curve (AUC) in distinguishing severe from non-severe fibrosis for Ki was 0.84 (95% CI [0.65,1.00]), and for CEI was 0.64 (95% CI [0.39, 0.89]) (p=0.0248). CV for Ki and CEI were 33.4 and 5.8, respectively. The only other parameter in the PK model having significant correlation with fibrosis stage was absolute arterial blood flow (Fa) (R=-0.48, 95% CI [-0.75,-0.05], p=0.03). Hepatocyte intracellular uptake rate, Ki, derived from DCE-MRI, correlates with fibrosis stage and may contribute to a non-invasive biomarker of hepatic fibrosis.