Department of Radiology, Gifu University Hospital, 1-1 Yanagido, 501-1194 Gifu, Japan.
J Magn Reson Imaging. 2012 Nov;36(5):1148-53. doi: 10.1002/jmri.23758. Epub 2012 Jul 30.
To develop and evaluate a quantitative parameter for staging hepatic fibrosis by contrast enhancement signal intensity and morphological measurements from gadoxetic acid (Gd-EOB-DTPA)-enhanced MR imaging.
MR images were obtained in 93 patients; 75 patients had histopathologically proven hepatic fibrosis and 18 patients who had healthy livers were evaluated. The liver-to-muscle signal intensity ratio (SI(post) = SIliver/SImuscle), contrast enhancement index (CEI = SIpost/SIpre), and liver-to-spleen volumetric ratio (VR = Vliver/Vspleen) were evaluated for staging hepatic fibrosis.
VR was most strongly correlated with fibrosis stage (7.21; r = -0.83; P < 0.001). Sensitivity, specificity, and area under the ROC curve demonstrated by linear regression formula generated by VR and CEI in predicting fibrous scores were 100%, 73%, and 0.91, respectively, for the detection of hepatic fibrosis F1 or greater (≥ F1),100%, 87%, and 0.96 for ≥ F2, 74%, 98%, and 0.93 for ≥ F3 and 91%, 100%, and 0.97 for F4.
The liver-to-spleen volumetric ratio and contrast enhancement index were reliable biomarkers for the staging of hepatic fibrosis on Gd-EOB-DTPA-enhanced MR imaging.
通过钆塞酸（Gd-EOB-DTPA）增强磁共振成像的对比增强信号强度和形态学测量，开发和评估一种用于肝纤维化分期的定量参数。
对 93 例患者进行了磁共振成像检查；75 例患者经组织病理学证实患有肝纤维化，18 例肝脏健康的患者作为对照。评估了肝-肌肉信号强度比（SI(post) = SIliver/SImuscle）、对比增强指数（CEI = SIpost/SIpre）和肝-脾容积比（VR = Vliver/Vspleen），用于分期肝纤维化。
VR 与纤维化分期相关性最强（7.21；r = -0.83；P < 0.001）。由 VR 和 CEI 生成的线性回归公式预测纤维评分时，VR 和 CEI 对肝纤维化 F1 或更高阶段（≥ F1）的检测具有 100%的敏感性、73%的特异性和 0.91 的ROC 曲线下面积，对≥ F2 的检测具有 100%的敏感性、87%的特异性和 0.96 的ROC 曲线下面积，对≥ F3 的检测具有 74%的敏感性、98%的特异性和 0.93 的ROC 曲线下面积，对 F4 的检测具有 91%的敏感性、100%的特异性和 0.97 的ROC 曲线下面积。
在 Gd-EOB-DTPA 增强磁共振成像上，肝-脾容积比和对比增强指数是肝纤维化分期的可靠生物标志物。
