Assessing liver fibrosis in chronic hepatitis B using MR extracellular volume measurements: Comparison with serum fibrosis indices
Assessing liver fibrosis in chronic hepatitis B using MR extracellular volume measurements: Comparison with serum fibrosis indices
复制标题
使用 MR 细胞外体积测量评估慢性乙型肝炎的肝纤维化：与血清纤维化指数的比较。
DOI：
10.1016/j.mri.2019.03.002
复制
发表时间：
2019-06-01
影响因子：
2.5
通讯作者：
Shen, Ruo-fan
中科院分区：
文献类型：
--
作者：
Wang, He-qing;Jin, Kai-pu;Shen, Ruo-fan
目的：评价平衡磁共振测量肝细胞外体积(ECVliver)对慢性乙型肝炎(CHB)患者肝纤维化分期的诊断价值，并与血清肝纤维化指标进行比较。材料与方法：91例CHB患者在造影剂增强前及造影剂增强后15min分别行肝细胞外体积(ECVliver)T1扫描。计算并比较肝纤维化亚组间ECVliver、天冬氨酸氨基转移酶/血小板比率指数(APRI)和基于四项指标的纤维化指数(FIB-4)，并用Spearman相关分析和逐步多元回归分析三项指标与纤维化分期和炎症活动的相关性。使用接收器操作特征分析评估和比较在评估肝纤维化分期方面的诊断性能。结果：观察者间一致性显示ECVliver具有良好的组间相关系数0.895。在肝纤维化分期(F/H=18.44~24.36，P=F3)和肝硬变(F=0.0024~0.0049)之间，ECVliver、APRI和FIB4的差异有统计学意义。结论：MRECVliver是一种无创的肝纤维化分期方法，优于APRI值和FIB4值。
Objectives: To evaluate the diagnostic value of liver extracellular volume (ECVliver) measurement by equilibrium MR in staging liver fibrosis in chronic hepatitis B (CHB) patients, and to compare its performance with serum fibrosis indices.Materials and methods: 91 CHB patients were included and underwent gadopentetate dimeglumine-enhanced MRI with T1 mapping sequence before and 15-min after contrast. ECVliver, aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (FIB-4) were calculated and compared between fibrosis subgroups, and the correlations between the three indices and fibrosis stage or inflammatory activity were measured by Spearman correlation analysis and stepwise multiple regression analysis. Diagnostic performance in evaluating liver fibrosis stage was assessed and compared using receiver operating characteristic analysis.Results: Interobserver agreement showed an excellent interclass correlation coefficient of 0.895 for ECVliver. ECVliver, APRI and FIB-4 were different between fibrosis stages as a whole (F/H = 18.44-24.36, P = F3) and cirrhosis (F4) (P = 0.0024 to 0.0049).Conclusion: MR ECVliver provides a promising noninvasive tool in staging liver fibrosis for CHB patients, superior to the fibrosis indices of APRI and FIB-4.