Magnetic Resonance Elastography Shear Wave Velocity Correlates with Liver Fibrosis and Hepatic Venous Pressure Gradient in Adults with Advanced Liver Disease.
Magnetic Resonance Elastography Shear Wave Velocity Correlates with Liver Fibrosis and Hepatic Venous Pressure Gradient in Adults with Advanced Liver Disease.
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DOI：
10.1155/2017/2067479
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发表时间：
2017
影响因子：
--
通讯作者：
Morse CG
中科院分区：
文献类型：
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作者：
Gharib AM;Han MAT;Meissner EG;Kleiner DE;Zhao X;McLaughlin M;Matthews L;Rizvi B;Abd-Elmoniem KZ;Sinkus R;Levy E;Koh C;Myers RP;Subramanian GM;Kottilil S;Heller T;Kovacs JA;Morse CG
背景。门静脉高压是肝静脉压力梯度 (HVPG) 的升高，可用于监测肝硬化的疾病进展和治疗反应。由于获得 HVPG 测量是侵入性的，因此需要可靠的非侵入性方法来评估门静脉高压。方法。纤维化的非侵入性标志物，包括磁共振弹性成像 (MRE) 剪切波速度，与参加一项抗 LOXL2 抗体 simtuzumab 治疗临床试验的丙型肝炎 (HCV) 和/或 HIV 感染的晚期肝病患者的组织学纤维化和 HVPG 测量值相关。结果。这项探索性分析包括 23 名受试者：9 名患有 HCV 单一感染，9 名患有 HIV 和 HCV，5 名患有 HIV 和非酒精性脂肪性肝炎。 Ishak 纤维化评分中位数为 4（范围 1-6）； 11 名受试者 (48%) 患有肝硬化。中位 HVPG 为 6mmHg（范围 3-16）。 MRE 测量的肝脏硬度与 HVPG（r = 0.64，p = 0.01）、组织学纤维化评分（r = 0.71，p = 0.004）、非侵袭性纤维化指数（包括 APRI（r = 0.81，p < 0.001）和可溶性 LOXL2（r = 0.82，p = 0.001））相关。在逐步多元回归分析中，MRE 是唯一与 HVPG 独立相关的变量（R2 = 0.377，p = 0.02）。结论。肝脏的 MRE 与 HVPG 独立相关。 MRE 是肝病严重程度的有效无创测量方法，并且可能被证明是无创门静脉高压评估的有用工具。试用注册号。该试验注册号为 NCT01707472。
Background. Portal hypertension, an elevation in the hepatic venous pressure gradient (HVPG), can be used to monitor disease progression and response to therapy in cirrhosis. Since obtaining HVPG measurements is invasive, reliable noninvasive methods of assessing portal hypertension are needed. Methods. Noninvasive markers of fibrosis, including magnetic resonance elastography (MRE) shear wave velocity, were correlated with histologic fibrosis and HVPG measurements in hepatitis C (HCV) and/or HIV-infected patients with advanced liver disease enrolled in a clinical trial of treatment with simtuzumab, an anti-LOXL2 antibody. Results. This exploratory analysis includes 23 subjects: 9 with HCV monoinfection, 9 with HIV and HCV, and 5 with HIV and nonalcoholic steatohepatitis. Median Ishak fibrosis score was 4 (range 1–6); 11 subjects (48%) had cirrhosis. Median HVPG was 6 mmHg (range 3–16). Liver stiffness measured by MRE correlated with HVPG (r = 0.64, p = 0.01), histologic fibrosis score (r = 0.71, p = 0.004), noninvasive fibrosis indices, including APRI (r = 0.81, p < 0.001), and soluble LOXL2 (r = 0.82, p = 0.001). On stepwise multivariate regression analysis, MRE was the only variable independently associated with HVPG (R2 = 0.377, p = 0.02). Conclusions. MRE of the liver correlated independently with HVPG. MRE is a valid noninvasive measure of liver disease severity and may prove to be a useful tool for noninvasive portal hypertension assessment. Trial Registration Number. This trial is registered with NCT01707472.