Susceptibility-weighted MR Imaging in the Grading of Liver Fibrosis: A Feasibility Study
Susceptibility-weighted MR Imaging in the Grading of Liver Fibrosis: A Feasibility Study
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DOI：
10.1148/radiol.13122440
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发表时间：
2014-01-01
期刊：
影响因子：
19.7
通讯作者：
Ba-Ssalamah, Ahmed
中科院分区：
文献类型：
--
作者：
Balassy, Csilla;Feier, Diana;Ba-Ssalamah, Ahmed
目的：评估磁共振（MR）磁共振加权（SW）成像作为一种工具，以评估肝纤维化等级的慢性肝病（CLD）患者利用信号强度（SI）的测量，与组织病理学结果作为参考standard.Materials和方法的可行性：这项回顾性研究是由当地的伦理委员会批准。所有受试者均提供了书面知情同意书。纳入了80例连续患者（平均年龄56.8岁），其中60%为男性[n = 48]，40%为女性[n = 32]，由于各种基础原因和组织病理学证实的肝纤维化而患有CLD。对活检进行肝纤维化和坏死性炎症活动（根据METAVIR评分系统）、铁负荷和脂肪变性评价。两名放射科医生对临床数据不知情，对肝脏和脊髓肌肉中的感兴趣区域进行了一致评估。通过单变量和多变量回归分析计算肝脏与肌肉的SI比值，并将其与组织病理学结果和临床数据相关联。肝-肌SI比值随肝纤维化程度的增加而降低，并与肝纤维化程度密切相关（r =-0.81，P < .0001）和中度坏死性炎症活动（r =-0.52，P < .0001）和铁负荷（r =-0.37，P = .0002），但与脂肪变性无关（r =-0.18，P = .11）。在多元回归分析中，肝纤维化和铁负荷独立影响SW成像测量，解释了69%的肝脏-肌肉SI比值的方差（R-2 = 0.69，P <0.001）。肝-肌SI比值在肝纤维化分级中表现良好，F2及以上评分的受试者工作特征曲线下面积为0.92，F4（肝硬化）评分的受试者工作特征曲线下面积为0.93。结论：SW成像是检测CLD患者中晚期肝纤维化的一种可行的无创工具。(C)RSNA，2013年
Purpose: To assess the feasiblity of magnetic resonance (MR) susceptibility-weighted (SW) imaging as a tool to evaluate liver fibrosis grades in patients with chronic liver diseases (CLD) utilizing signal intensity (SI) measurements, with histopathologic findings as the reference standard.Materials and Methods: This retrospective study was approved by the local ethics committee. All subjects gave written informed consent. Eighty consecutive patients (mean age, 56.8 years), 60% of whom were male [n = 48] and 40% of whom were female [n = 32], with CLD due to various underlying causes and histopathologically proved liver fibrosis were included. Biopsies were evaluated for liver fibrosis and necroinflammatory activity (according to METAVIR scoring system), iron load, and steatosis. Two radiologists, blinded to the clinical data, assessed regions of interest in the liver and spinal muscle in consensus. Liver-to-muscle SI ratios were calculated and correlated to histopathologic findings and clinical data by using univariate and multivariate regression analysis.Results: Liver-to-muscle SI ratio decreased in parallel with the increasing grade of liver fibrosis and correlated strongly with liver fibrosis (r = -0.81, P < .0001) and moderately with necroinflammatory activity (r = -0.52, P < .0001) and iron load (r = -0.37, P = .0002) but did not correlate with steatosis (r = -0.18, P = .11). In multiple regression analysis, liver fibrosis and iron load independently influenced SW imaging measurements, explaining 69% of the variance of liver-to-muscle SI ratio (R-2 = 0.69, P < .001). Liver-to-muscle SI ratio performed well in grading liver fibrosis, with an area under the receiver operating characteristic curve of 0.92 for scores of F2 or higher and 0.93 for score of F4 (liver cirrhosis).Conclusion: SW imaging is a feasible noninvasive tool to detect moderate and advanced liver fibrosis in CLD patients. (C) RSNA, 2013