Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
J Magn Reson Imaging. 2011 Nov;34(5):1110-6. doi: 10.1002/jmri.22723. Epub 2011 Sep 19.
To determine the sensitivity and specificity of MR elastography (MRE) in the staging of hepatic fibrosis (HF) using histopathology as the reference standard in an Asian population.
MRE was performed on 55 patients with chronic liver diseases or biliary diseases and on 5 living related liver donors (48 men and 12 women; mean age, 55.7 years). MRE was performed with modified, phase-contrast, gradient-echo sequences, and the mean stiffness values were measured on the elastograms in kilopascals(kPa). Receiver operating characteristic curve analysis was performed to determine the cutoff value and accuracy of MRE for staging HF. Histopathologic staging of HF according to the METAVIR scoring system served as the reference.
Liver stiffness increased systematically along with the fibrosis stage. With a shear stiffness cutoff value of 3.05 kPa, the predicted sensitivity and specificity for differentiating significant liver fibrosis (≥ F2) from mild fibrosis (F1) were 89.7% and 87.1%, respectively. In addition, MRE was able to discriminate between patients with severe fibrosis (F3) and those with liver cirrhosis (sensitivity, 100%; specificity, 92.2%), with a shear stiffness cutoff value of 5.32 kPa.
MRE could be a promising, noninvasive technique with excellent diagnostic accuracy for detecting significant HF and liver cirrhosis.
使用组织病理学作为参考标准，确定磁共振弹性成像（MRE）在亚洲人群中对肝纤维化（HF）分期的敏感性和特异性。
对 55 例慢性肝病或胆道疾病患者和 5 例活体相关肝供体（48 名男性和 12 名女性；平均年龄，55.7 岁）进行 MRE 检查。MRE 采用改良的相位对比梯度回波序列进行，在弹性图像上测量平均硬度值（kPa）。进行受试者工作特征曲线分析，以确定 MRE 分期 HF 的截断值和准确性。根据 METAVIR 评分系统进行组织病理学 HF 分期作为参考。
肝脏硬度随纤维化分期系统而升高。当剪切硬度截断值为 3.05 kPa 时，预测区分明显纤维化（≥F2）和轻度纤维化（F1）的敏感性和特异性分别为 89.7%和 87.1%。此外，MRE 能够区分严重纤维化（F3）和肝硬化患者（敏感性，100%；特异性，92.2%），剪切硬度截断值为 5.32 kPa。
MRE 可能是一种很有前途的、非侵入性技术，具有检测明显 HF 和肝硬化的优异诊断准确性。
