Department of Radiology, National University Health System, 5, Lower Kent Ridge Road, Singapore, Singapore,
Eur Radiol. 2014 Jan;24(1):70-8. doi: 10.1007/s00330-013-2978-8. Epub 2013 Aug 9.
We measured the accuracy of magnetic resonance elastography (MRE) for the detection and staging of liver fibrosis in chronic hepatitis B (CHB) and compared it with serum fibrosis markers.
Prospective comparison of MRE and routine serum fibrosis markers, namely serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), ALT/AST ratio (AAR), AST to platelet ratio index (APRI) and prothrombin index (PI), was performed in 63 consecutive CHB patients who underwent MRE and histological confirmation of liver fibrosis within a 6-month interval. Diagnostic performance of MRE and serum markers for staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4) was compared.
The study group comprised 63 patients (19 female; mean age ± SD, 50 ± 11.9 years). MRE (ρ = 0.94, P < 0.0001), APRI (ρ = 0.42, P = 0.0006), PI (ρ = 0.42, P = 0.0006) and AST (ρ = 0.28, P = 0.028) results correlated significantly with fibrosis stage. MRE was significantly more accurate than serum fibrosis markers for the detection of significant fibrosis (0.99 vs. 0.55-0.73) and cirrhosis (0.98 vs. 0.53-0.77). Sensitivity, specificity, positive predictive and negative predictive values for MRE for significant fibrosis and cirrhosis were 97.4 %, 100 %, 100 % and 96 %, and 100 %, 95.2 %, 91.3 % and 100 %, respectively.
MRE is an accurate non-invasive technique for the detection and staging of liver fibrosis in CHB.
• Magnetic resonance elastography is accurate for liver fibrosis detection and staging. • MR elastography is more accurate than serum tests for staging liver fibrosis. • MR elastography can potentially replace liver biopsy in chronic hepatitis B.
我们测量磁共振弹性成像（MRE）检测和分期慢性乙型肝炎（CHB）肝纤维化的准确性，并将其与血清纤维化标志物进行比较。
前瞻性比较 MRE 和常规血清纤维化标志物，即血清丙氨酸氨基转移酶（ALT）、血清天冬氨酸氨基转移酶（AST）、ALT/AST 比值（AAR）、AST 与血小板比值指数（APRI）和凝血酶原指数（PI），对 63 例连续接受 MRE 检查且在 6 个月内通过肝组织学证实存在肝纤维化的 CHB 患者进行研究。比较 MRE 和血清标志物对纤维化分期（≥F1）、显著纤维化（≥F2）、进展性纤维化（≥F3）和肝硬化（F4）的诊断性能。
研究组包括 63 例患者（19 例女性；平均年龄±标准差，50±11.9 岁）。MRE（ρ=0.94，P<0.0001）、APRI（ρ=0.42，P=0.0006）、PI（ρ=0.42，P=0.0006）和 AST（ρ=0.28，P=0.028）结果与纤维化分期显著相关。MRE 在检测显著纤维化（0.99 与 0.55-0.73）和肝硬化（0.98 与 0.53-0.77）方面明显优于血清纤维化标志物。MRE 对显著纤维化和肝硬化的检测的敏感性、特异性、阳性预测值和阴性预测值分别为 97.4%、100%、100%和 96%，以及 100%、95.2%、91.3%和 100%。
MRE 是一种准确的无创技术，可用于检测和分期 CHB 患者的肝纤维化。
磁共振弹性成像（MRE）可准确检测和分期肝纤维化。
MRE 比血清检测更准确地分期肝纤维化。
MRE 可能在慢性乙型肝炎中替代肝活检。
