Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease.
Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease.
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DOI：
10.1016/j.jhep.2013.09.002
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发表时间：
2014-01
影响因子：
25.7
通讯作者：
Neubauer, Stefan
中科院分区：
文献类型：
--
作者：
Banerjee, Rajarshi;Pavlides, Michael;Tunnicliffe, Elizabeth M.;Piechnik, Stefan K.;Sarania, Nikita;Philips, Rachel;Collier, Jane D.;Booth, Jonathan C.;Schneider, Jurgen E.;Wang, Lai Mun;Delaney, David W.;Fleming, Ken A.;Robson, Matthew D.;Barnes, Eleanor;Neubauer, Stefan
关键词：
随着世界范围内肝脏疾病的日益流行，临床迫切需要可靠的方法来诊断和分期肝脏病理。肝活检是目前的金标准，它是有创的，并受到采样和观察者依赖的变异性的限制。在这项研究中，我们的目标是评估一种新的磁共振方案对肝组织特征的诊断准确性。我们进行了一项前瞻性研究，将我们的磁共振技术与肝脏活检进行了比较。扫描方案的单独组件是T1图、质子波谱和T2⁎图，分别量化肝纤维化、脂肪变性和血黄素沉着症。作为其常规护理的一部分，未经选择的成年患者被转介进行肝脏活检。对组织学结果视而不见的医生对肝脏活检前进行的扫描进行了分析。评估磁共振和组织学变量之间的关系。还进行了接收器工作特性分析。79名患者获得了配对的磁共振和活检数据。磁共振测量与组织学密切相关(对于纤维化，rS=0.68；0.0001；对于脂肪变性，rS=0.89；0.001；对于血黄素沉着症，rS=0.69；−；0.0001)。受试者工作特征曲线下面积分别为0.94、0.93和0.94，可诊断任何程度的纤维化、脂肪变性和含铁血黄素沉着症。这种新的扫描方法为评估肝纤维化、脂肪变性和含铁血黄素沉着症提供了很高的诊断准确率，并有可能在许多适应症上取代肝活检。这是首次使用非侵入性测试来区分早期肝纤维化和正常肝。
With the increasing prevalence of liver disease worldwide, there is an urgent clinical need for reliable methods to diagnose and stage liver pathology. Liver biopsy, the current gold standard, is invasive and limited by sampling and observer dependent variability. In this study, we aimed to assess the diagnostic accuracy of a novel magnetic resonance protocol for liver tissue characterisation. We conducted a prospective study comparing our magnetic resonance technique against liver biopsy. The individual components of the scanning protocol were T1 mapping, proton spectroscopy and T2⁎ mapping, which quantified liver fibrosis, steatosis and haemosiderosis, respectively. Unselected adult patients referred for liver biopsy as part of their routine care were recruited. Scans performed prior to liver biopsy were analysed by physicians blinded to the histology results. The associations between magnetic resonance and histology variables were assessed. Receiver-operating characteristic analyses were also carried out. Paired magnetic resonance and biopsy data were obtained in 79 patients. Magnetic resonance measures correlated strongly with histology (rs = 0.68 p <0.0001 for fibrosis; rs = 0.89 p <0.001 for steatosis; rs = −0.69 p <0.0001 for haemosiderosis). The area under the receiver operating characteristic curve was 0.94, 0.93, and 0.94 for the diagnosis of any degree of fibrosis, steatosis and haemosiderosis respectively. The novel scanning method described here provides high diagnostic accuracy for the assessment of liver fibrosis, steatosis and haemosiderosis and could potentially replace liver biopsy for many indications. This is the first demonstration of a non-invasive test to differentiate early stages of fibrosis from normal liver.
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影响因子：
5
作者：
Chandarana, Hersh;Lim, Ruth P.;Taouli, Bachir
通讯作者：
Taouli, Bachir
影响因子：
9.8
作者：
Regev, A;Berho, M;Schiff, ER
通讯作者：
Schiff, ER
DOI：
10.1002/path.1700840107
发表时间：
1962-01-01
期刊：
JOURNAL OF PATHOLOGY AND BACTERIOLOGY
影响因子：
--
作者：
SCHEUER, PJ;WILLIAMS, R;MUIR, AR
通讯作者：
MUIR, AR
影响因子：
2.4
作者：
Mariappan, Yogesh K.;Glaser, Kevin J.;Ehman, Richard L.
通讯作者：
Ehman, Richard L.
影响因子：
13.5
作者：
Kleiner, DE;Brunt, EM;Sanyal, AJ
通讯作者：
Sanyal, AJ