Department of Radiology and Medical Imaging, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Rd, Taipei, Taiwan.
Eur Radiol. 2012 Jan;22(1):171-80. doi: 10.1007/s00330-011-2249-5. Epub 2011 Aug 31.
To develop a non-invasive MRI method for evaluation of liver fibrosis, with histological analysis as the reference standard.
The study protocol was approved by the Institutional Review Board for Human Studies of our hospital, and written informed consent was obtained from all subjects. Seventy-nine subjects who received dynamic contrast-enhanced MRI (DCE-MRI) with Gd-EOB-DTPA were divided into three subgroups according to Metavir score: no fibrosis (n = 30), mild fibrosis (n = 34), and advanced fibrosis (n = 15). The DCE-MRI parameters were measured using two models: (1) dual-input single-compartment model for arterial blood flow (F (a)), portal venous blood flow, total liver blood flow, arterial fraction (ART), distribution volume, and mean transit time; and (2) curve analysis model for Peak, Slope, and AUC. Statistical analysis was performed with Student's t-test and the nonparametric Kruskal-Wallis test.
Slope and AUC were two best perfusion parameters to predict the severity of liver fibrosis (>F2 vs. ≦F2). Four significantly different variables were found between non-fibrotic versus mild-fibrotic subgroups: F (a), ART, Slope, and AUC; the best predictor for mild fibrosis was F (a) (AUROC:0.701).
DCE-MRI with Gd-EOB-DTPA is a noninvasive imaging, by which multiple perfusion parameters can be measured to evaluate the severity of liver fibrosis.
开发一种评估肝纤维化的非侵入性 MRI 方法，以组织学分析作为参考标准。
本研究方案获得了我院人体研究伦理委员会的批准，并获得了所有受试者的书面知情同意。79 例接受钆塞酸二钠（Gd-EOB-DTPA）动态对比增强 MRI（DCE-MRI）的患者根据 Metavir 评分分为三组：无纤维化（n=30）、轻度纤维化（n=34）和进展性纤维化（n=15）。使用两种模型测量 DCE-MRI 参数：（1）双输入单室模型用于动脉血流（F(a)）、门静脉血流、总肝血流、动脉分数（ART）、分布容积和平均通过时间；（2）曲线分析模型用于峰值、斜率和 AUC。使用 Student's t 检验和非参数 Kruskal-Wallis 检验进行统计分析。
斜率和 AUC 是预测肝纤维化严重程度（>F2 与 ≦F2）的两个最佳灌注参数。在无纤维化与轻度纤维化亚组之间发现了四个显著不同的变量：F(a)、ART、斜率和 AUC；预测轻度纤维化的最佳指标是 F(a)（AUROC：0.701）。
Gd-EOB-DTPA 的 DCE-MRI 是一种非侵入性成像方法，可通过测量多个灌注参数来评估肝纤维化的严重程度。
