A comparison of MR elastography and 31P MR spectroscopy with histological staging of liver fibrosis
A comparison of MR elastography and 31P MR spectroscopy with histological staging of liver fibrosis
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DOI：
10.1007/s00330-012-2527-x
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发表时间：
2012-12-01
影响因子：
5.9
通讯作者：
Lomas, David J.
中科院分区：
文献类型：
--
作者：
Godfrey, Edmund M.;Patterson, Andrew J.;Lomas, David J.
目的 传统成像技术对肝纤维化不敏感。本研究评估了 MR 弹性成像 (MRE) 刚度值和使用 P-31 光谱测量的磷酸单酯 (PME)/磷酸二酯 (PDE) 比率与组织学纤维化分期的诊断准确性。方法 当地研究伦理委员会批准了这项前瞻性、盲法研究。当天晚些时候，共有 77 名临床怀疑患有肝纤维化的连续患者（55 名男性，年龄 49 +/- 11.5 岁）接受了 MR 检查和肝活检。患者在 1.5 T 全身系统上接受了 MRE 和 P-31 波谱检查。使用慢性肝炎的 Ishak 评分或脂肪肝疾病的改良 NAS 纤维化评分对肝脏活检进行分期。结果 MRE 随纤维化分期增加并呈正相关（Spearman 等级 = 0.622，P < 0.001）。 PME/PDE 与纤维化阶段无关（Spearman 等级 = -0.041，p = 0.741）。 MRE 刚度值的受试者工作曲线下面积较高（范围 0.75-0.97）。 PME/PDE 的诊断效用并不比偶然性更好（范围 0.44-0.58）。 结论 MRE 估计的肝脏硬度随着纤维化阶段的增加而增加，并且能够对纤维化阶段进行二分。我们没有发现 P-31 磁共振波谱与纤维化阶段之间的关系。
Objectives Conventional imaging techniques are insensitive to liver fibrosis. This study assesses the diagnostic accuracy of MR elastography (MRE) stiffness values and the ratio of phosphomonoesters (PME)/phosphodiesters (PDE) measured using P-31 spectroscopy against histological fibrosis staging.Methods The local research ethics committee approved this prospective, blinded study. A total of 77 consecutive patients (55 male, aged 49 +/- 11.5 years) with a clinical suspicion of liver fibrosis underwent an MR examination with a liver biopsy later the same day. Patients underwent MRE and P-31 spectroscopy on a 1.5 T whole body system. The liver biopsies were staged using an Ishak score for chronic hepatitis or a modified NAS fibrosis score for fatty liver disease.Results MRE increased with and was positively associated with fibrosis stage (Spearman's rank = 0.622, P < 0.001). PME/PDE was not associated with fibrosis stage (Spearman's rank = -0.041, p = 0.741). Area under receiver operating curves for MRE stiffness values were high (range 0.75-0.97). The diagnostic utility of PME/PDE was no better than chance (range 0.44-0.58).Conclusions MRE-estimated liver stiffness increases with fibrosis stage and is able to dichotomise fibrosis stage groupings. We did not find a relationship between P-31 MR spectroscopy and fibrosis stage.