Hepatic Iron Deposition in Patients With Liver Disease: Preliminary Experience With Breath-Hold Multiecho T2*-Weighted Sequence
Hepatic Iron Deposition in Patients With Liver Disease: Preliminary Experience With Breath-Hold Multiecho T2*-Weighted Sequence
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DOI：
10.2214/ajr.08.1996
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发表时间：
2009-11-01
影响因子：
5
通讯作者：
Taouli, Bachir
中科院分区：
文献类型：
--
作者：
Chandarana, Hersh;Lim, Ruth P.;Taouli, Bachir
目标。本研究的目的是以组织病理学检查为参考标准，对屏气多回声T2加权序列在肝病患者肝脏铁沉积的检测和定量中的应用进行初步评价。对43例肝脏疾病患者进行了肝脏1.5-T磁共振成像，其中包括一个多回波T2加权序列，这些患者还同时接受了肝活检或肝移植。两个独立的观察者通过在肝实质中放置感兴趣区域来测量肝脏T2*。比较按肝铁分级分级的患者之间的肝脏T2*值，并与组织病理学铁分级相关。接收器操作特性分析用于评估肝脏T2加权序列图像诊断铁沉积的准确性。结果：有铁沉积的患者的肝脏T2*值比无铁沉积的患者短(平均T2*，17.7ms vs32.3ms，来自两个观察者的汇集数据；p<；0.0001)。铁级别为3或更高的患者比铁级别为2或更低的患者的T2*值更短(10.1vs20.8毫秒；p<；0.0001)。肝脏T2*与组织学铁分级呈显著负相关(r=-0.849；p<；0.0001)。以T2*<24毫秒和<14毫秒为临界点，曲线下面积、灵敏度和特异度分别为0.968~0.982、90.5~100%和100~97.3%。结论：屏气T2加权序列可以快速、准确地评价肝病患者的肝脏铁负荷。
OBJECTIVE. The purpose of this study was to conduct, using histopathologic examination as the reference standard, a preliminary evaluation of the use of a breath-hold multiecho T2*-weighted MRI sequence in the detection and quantification of hepatic iron deposition in patients with liver disease.MATERIALS AND METHODS. The images of 43 patients with liver disease who underwent 1.5-T MRI of the liver that included a multiecho T2*-weighted sequence who also underwent concomitant liver biopsy or liver transplantation were assessed. Two independent observers measured hepatic T2* by placing regions of interest in the hepatic parenchyma. Hepatic T2* values were compared between patients stratified by hepatic iron grade and were correlated with histopathologic iron grade. Receiver operating characteristics analysis was performed to assess the accuracy of images obtained with the hepatic T2*-weighted sequence in the diagnosis of iron deposition.RESULTS. Patients with iron deposition had shorter hepatic T2* values than did patients without iron deposition (mean T2*, 17.7 vs 32.3 milliseconds with pooled data from both observers; p < 0.0001). Patients with iron grade 3 or greater had shorter T2* values than those with iron grade 2 or less (10.1 vs 20.8 milliseconds; p < 0.0001). There was a strong negative correlation between hepatic T2* and histopathologic iron grade (r = -0.849; p < 0.0001). For the prediction of iron grades 1 or greater and 3 or greater, area under the curve, sensitivity, and specificity were 0.968-0.982, 90.5-100%, and 100-97.3% at T2* cutoffs of less than 24 and less than 14 milliseconds, respectively.CONCLUSION. Hepatic iron overload in patients with liver disease can be assessed rapidly and accurately with MRI performed with a breath-hold T2*-weighted sequence.