Magnetic resonance elastography for the noninvasive staging of liver fibrosis
Magnetic resonance elastography for the noninvasive staging of liver fibrosis
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DOI：
10.1053/j.gastro.2008.03.076
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发表时间：
2008-07-01
期刊：
影响因子：
29.4
通讯作者：
Van Beers, Bernard E.
中科院分区：
文献类型：
--
作者：
Huwart, Laurent;Sempoux, Christine;Van Beers, Bernard E.
背景和目标：本研究的目的是前瞻性比较磁共振弹性成像、超声弹性成像和天冬氨酸转氨酶与血小板比率指数（APRI）测量对慢性肝病患者纤维化非侵入性分期的成功率和诊断准确性。研究方法：我们对在一所大学医院接受慢性肝病肝活检的连续系列患者进行了磁共振弹性成像、超声弹性成像和APRI的前瞻性盲法比较。根据METAVIR评分系统的肝纤维化组织学分期作为参考。结果：共有141名患者接受了评估。磁共振弹性成像的技术成功率高于超声弹性成像（133/141 [94%] vs 118/141 [84%]; P = 0.016）。96例患者的磁和超声弹性成像、APRI测量和肝活检标本的组织病理学分析在技术上成功。磁共振弹性的受试者工作特性曲线下面积（F >= 2为0.994; F >= 3为0.985; F = 4为0.998）与超声弹性、APRI及超声弹性与APRI联合检测相比，（对于F >= 2，分别为0.837、0.709和0.849;对于F >= 3，分别为0.906、0.816和0.936;对于F = 4，分别为0.930、0.820和0.944）。结论：磁共振弹性成像技术的成功率高于超声弹性成像，诊断肝纤维化的准确性高于超声弹性成像和APRI。
Background & Aims: The purpose of our study was to prospectively compare the success rate and diagnostic accuracy of magnetic resonance elastography, ultrasound elastography, and aspartate aminotransferase to platelets ratio index (APRI) measurements for the noninvasive staging of fibrosis in patients with chronic liver disease. Methods: We performed a prospective blind comparison of magnetic resonance elastography, ultrasound elastography, and APRI in a consecutive series of patients who underwent liver biopsy for chronic liver disease in a university-based hospital. Histopathologic staging of liver fibrosis according to the METAVIR scoring system served as the reference. Results: A total of 141 patients were assessed. The technical success rate of magnetic resonance elastography was higher than that of ultrasound elastography (133/141 [94%] vs 118/141 [84%]; P = .016). Magnetic and ultrasound elastography, APRI measurements, and histopathologic analysis of liver biopsy specimens were technically successful in 96 patients. The areas under the receiver operating characteristic curves of magnetic resonance elasticity (0.994 for F >= 2; 0.985 for F >= 3; 0.998 for F = 4) were larger (P < .05) than those of ultrasound elasticity, APRI, and the combination of ultrasound elasticity and APRI (0.837, 0.709, and 0.849 for F >= 2; 0.906, 0.816, and 0.936 for F >= 3; 0.930, 0.820, and 0.944 for F = 4, respectively). Conclusions: Magnetic resonance elastography has a higher technical success rate than ultrasound elastography and a better diagnostic accuracy than ultrasound elastography and APRI for staging liver fibrosis.