Zhou Li, Chen Tian-wu, Zhang Xiao-ming, Li Cheng-jun, Yang Zhen-feng, Zeng Nan-lin, Wang Li-ying, Li Ting, Wang Dan, Li Jie, Li Chun-ping, Li Li, Xie Xian-yong
Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Department of Anatomy, and Morphometric Research Laboratory, North Sichuan Medical College, Nanchong, Sichuan, China.
PLoS One. 2013 Dec 20;8(12):e83697. doi: 10.1371/journal.pone.0083697. eCollection 2013.
To explore spleen hemodynamic alteration in liver fibrosis with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and to determine how to stage liver fibrosis with spleen DCE-MRI parameters.
Sixteen piglets were prospectively used to model liver fibrosis staged by liver biopsy, and underwent spleen DCE-MRI on 0, 5th, 9th, 16th and 21st weekend after modeling this disease. DCE-MRI parameters including time to peak (TTP), positive enhancement integral (PEI), maximum slope of increase (MSI) and maximum slope of decrease (MSD) of spleen were measured, and statistically analyzed to stage this disease.
Spearman's rank correlation tests showed that TTP tended to increase with increasing stages of liver fibrosis (r = 0.647, P<0.001), and that PEI tended to decrease from stage 0 to 4 (r = -0.709, P<0.001). MSD increased slightly from stage 0 to 2 (P>0.05), and decreased from stage 2 to 4 (P<0.05). MSI increased from stage 0 to 1, and decreased from stage 1 to 4 (all P>0.05). Mann-Whitney tests demonstrated that TTP and PEI could classify fibrosis between stage 0 and 1-4, between 0-1 and 2-4, between 0-2 and 3-4, or between 0-3 and 4 (all P<0.01). MSD could discriminate between 0-2 and 3-4 (P = 0.006), or between 0-3 and 4 (P = 0.012). MSI could not differentiate between any two stages. Receiver operating characteristic analysis illustrated that area under receiver operating characteristic curve (AUC) of TTP was larger than of PEI for classifying stage ≥1 and ≥2 (AUC = 0.851 and 0.783, respectively). PEI could best classify stage ≥3 and 4 (AUC = 0.903 and 0.96, respectively).
Spleen DCE-MRI has potential to monitor spleen hemodynamic alteration and classify liver fibrosis stages.
利用动态对比增强磁共振成像（DCE-MRI）探讨肝纤维化时脾脏血流动力学改变，并确定如何用脾脏DCE-MRI参数对肝纤维化进行分期。
前瞻性选取16头仔猪建立肝活检分期的肝纤维化模型，并于建模后第0、5、9、16和21周周末进行脾脏DCE-MRI检查。测量脾脏的DCE-MRI参数，包括达峰时间（TTP）、强化正积分（PEI）、最大上升斜率（MSI）和最大下降斜率（MSD），并进行统计分析以对疾病进行分期。
Spearman等级相关检验显示，TTP随肝纤维化分期增加而呈上升趋势（r = 0.647，P<0.001），PEI从0期到4期呈下降趋势（r = -0.709，P<0.001）。MSD从0期到2期略有增加（P>0.05），从2期到4期下降（P<0.05）。MSI从0期到1期增加，从1期到4期下降（均P>0.05）。Mann-Whitney检验表明，TTP和PEI可区分0期与1-4期、0-1期与2-4期、0-2期与3-4期或0-3期与4期之间（均P<0.01）。MSD可区分0-2期与3-4期（P = 0.006），或0-3期与4期（P = 0.012）。MSI不能区分任何两个分期。受试者工作特征分析表明，对于≥1期和≥2期的分类，TTP的受试者工作特征曲线下面积（AUC）大于PEI（分别为AUC = 0.851和0.783）。PEI对≥3期和4期的分类最佳（分别为AUC = 0.903和0.96）。
脾脏DCE-MRI有潜力监测脾脏血流动力学改变并对肝纤维化分期。
