Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study.
Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study.
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DOI：
10.1002/hep.27362
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发表时间：
2014-12
期刊：
影响因子：
13.5
通讯作者：
Sirlin, Claude
中科院分区：
文献类型：
--
作者：
Loomba, Rohit;Wolfson, Tanya;Ang, Brandon;Hooker, Jonathan;Behling, Cynthia;Peterson, Michael;Valasek, Mark;Lin, Grace;Brenner, David;Gamst, Anthony;Ehman, Richard;Sirlin, Claude
回顾性研究表明，二维磁共振弹性成像（2D-MRE），一种用于评估肝脏硬度的新型MR方法，与非酒精性脂肪性肝病（NAFLD）患者的晚期纤维化相关。需要关于2D-MRE在NAFLD晚期纤维化检测中诊断准确性的前瞻性数据。本研究的目的是前瞻性评估2D-MRE（一种非侵入性成像生物标志物）在预测活检证实的NAFLD患者中晚期纤维化（3期或4期）的诊断准确性。这是一项前瞻性研究的横断面分析，包括117例连续活检证实的NAFLD患者（56%为女性），这些患者接受了标准化研究访视：病史、检查、肝活检评估（使用非酒精性脂肪性肝炎临床研究网络组织学评分系统）和2011年至2013年的2D-MRE。放射科医生和病理科医生分别对临床和病理学/成像数据设盲。检查受试者操作特征（ROC）以评估2D-MRE在预测晚期纤维化中的诊断测试性能。年龄和体重指数的平均值（±标准差）分别为50.1（± 13.4）岁和32.4（± 5.0）kg/m2。活检和2D-MRE之间的中位时间间隔为45天（四分位距：50天）。0、1、2、3和4期纤维化患者数量分别为43、39、13、12和10例。2D-MRE区分晚期纤维化（3-4期）和0-2期纤维化的ROC曲线下面积为0.924（P < 0.0001）。阈值>3.63 kPa的敏感性为0.86（95%置信区间[CI]：0.65-0.97），特异性为0.91（95% CI：0.83-0.96），阳性预测值为0.68（95% CI：0.48-0.84），阴性预测值为0.97（95% CI：0.91-0.99）。结论：MRE在预测晚期纤维化方面是准确的，并且可用于NAFLD患者中晚期纤维化的非侵入性诊断。（Hepatology 2014;60：1920-1928）
Retrospective studies have shown that two-dimensional magnetic resonance elastography (2D-MRE), a novel MR method for assessment of liver stiffness, correlates with advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Prospective data on diagnostic accuracy of 2D-MRE in the detection of advanced fibrosis in NAFLD are needed. The aim of this study is to prospectively assess the diagnostic accuracy of 2D-MRE, a noninvasive imaging biomarker, in predicting advanced fibrosis (stage 3 or 4) in well-characterized patients with biopsy-proven NAFLD. This is a cross-sectional analysis of a prospective study including 117 consecutive patients (56% women) with biopsy-proven NAFLD who underwent a standardized research visit: history, exam, liver biopsy assessment (using the nonalcoholic steatohepatitis Clinical Research Network histological scoring system), and 2D-MRE from 2011 to 2013. The radiologist and pathologist were blinded to clinical and pathology/imaging data, respectively. Receiver operating characteristics (ROCs) were examined to assess the diagnostic test performance of 2D-MRE in predicting advanced fibrosis. The mean (± standard deviation) of age and body mass index was 50.1 (± 13.4) years and 32.4 (± 5.0) kg/m2, respectively. The median time interval between biopsy and 2D-MRE was 45 days (interquartile range: 50 days). The number of patients with fibrosis stages 0, 1, 2, 3, and 4 was 43, 39, 13, 12, and 10, respectively. The area under the ROC curve for 2D-MRE discriminating advanced fibrosis (stage 3-4) from stage 0-2 fibrosis was 0.924 (P < 0.0001). A threshold of >3.63 kPa had a sensitivity of 0.86 (95% confidence interval [CI]: 0.65-0.97), specificity of 0.91 (95% CI: 0.83-0.96), positive predictive value of 0.68 (95% CI: 0.48-0.84), and negative predictive value of 0.97 (95% CI: 0.91-0.99). Conclusions: MRE is accurate in predicting advanced fibrosis and may be utilized for noninvasive diagnosis of advanced fibrosis in patients with NAFLD. (Hepatology 2014;60:1920–1928)
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影响因子：
2.3
作者：
DITTRICH, M;MILDE, S;WEITZEL, D
通讯作者：
WEITZEL, D
影响因子：
3.7
作者：
Kim SU;Lee JH;Kim DY;Ahn SH;Jung KS;Choi EH;Park YN;Han KH;Chon CY;Park JY
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Park JY
影响因子：
168.9
作者：
Imbert-Bismut, F;Ratziu, V;Poynard, T
通讯作者：
Poynard, T
影响因子：
19.7
作者：
HANLEY, JA;MCNEIL, BJ
通讯作者：
MCNEIL, BJ
影响因子：
13.5
作者：
Jung, Kyu Sik;Kim, Seung Up;Han, Kwang-Hyub
通讯作者：
Han, Kwang-Hyub