Non-invasive assessment of hepatic fibrosis: comparison of MR elastography to transient elastography and intravoxel incoherent motion diffusion-weighted MRI
Non-invasive assessment of hepatic fibrosis: comparison of MR elastography to transient elastography and intravoxel incoherent motion diffusion-weighted MRI
复制标题
肝纤维化的无创评估：MR 弹性成像与瞬时弹性成像和体素内不相干运动扩散加权 MRI 的比较
DOI：
10.1007/s00261-019-02140-x
复制
发表时间：
2020-01-01
影响因子：
2.4
通讯作者：
Wang, Meiyun
中科院分区：
文献类型：
--
作者：
Fu, Fangfang;Li, Xiaodong;Wang, Meiyun
目的比较磁共振弹性成像（MRE）、瞬时弹性成像（TE）和体素内非相干运动（IVIM）弥散加权成像（DWI）对肝纤维化（HF）分期的价值。测量MRE的肝脏硬度测量值（LSM-MRE）和TE的肝脏硬度测量值（LSM-TE）;计算真扩散系数（Dt）、假扩散系数、灌注分数（f）和表观扩散系数（ADC）四个扩散参数。结果LSM-MRE和LSM-TE值与肝纤维化分期呈正相关Dt、f和ADC值与纤维化分期呈负相关（r=-0.727、-0.503和-0.601，P均< 0.001）。LSM-MRE的ROC曲线下面积（AUC）（AUC = 0.965，0.957，0.983）显著高于LSM-TE（AUC = 0.906，0.913，0.931）和Dt（AUC = 0.875，0.879，0.861）在区分严重HF（≥ F2）、晚期HF（≥ F3）和肝硬化（F4）方面均P < 0.05。结论MRE对严重肝纤维化、晚期肝纤维化的诊断能力优于TE和IVIM，TE和IVIM的诊断能力相当。
ObjectiveTo compare the ability of MR elastography (MRE) with transient elastography (TE) and intravoxel incoherent motion (IVIM) diffusion-weighted MRI in staging hepatic fibrosis (HF).Materials and methods100 patients with chronic liver disease and 25 healthy volunteers underwent preoperative MRE, IVIM on a 3T MRI unit, and ultrasound-based TE. Liver stiffness measurement from MRE (LSM-MRE) and liver stiffness measurement from TE (LSM-TE) were measured; four diffusion parameters including the true diffusion coefficient (Dt), pseudo-diffusion coefficient, perfusion fraction (f), and apparent diffusion coefficient (ADC) were calculated. Receiver operating characteristic (ROC) curves were performed for significant parameters to compare the diagnosis performance for detecting HF.ResultsLSM-MRE and LSM-TE values showed positive correlation with the fibrosis stage (r= 0.910 and 0.813,P< 0.001).Dt,f, and ADC values showed negative correlation with the fibrosis stage (r= − 0.727, − 0.503, and − 0.601, allP< 0.001). The area under the ROC curve (AUC) of LSM-MRE (AUC = 0.965, 0.957, 0.983) was significantly higher than that of LSM-TE (AUC = 0.906, 0.913, 0.931) andDt(AUC = 0.875, 0.879, 0.861) in discriminating significant HF (≥ F2), advanced HF (≥ F3), or cirrhosis (F4) (allP< 0.05). Although LSM-TE showed higher AUCs thanDtin detecting fibrosis stages, there were no significant differences between LSM-TE andDt(P> 0.05) except for detecting F4 (P< 0.05).ConclusionMRE shows excellent diagnostic performance for predicting significant fibrosis, advanced fibrosis compared with TE and IVIM, while TE and IVIM have comparable diagnostic performance.