Papalavrentios Lavrentios, Sinakos Emmanouil, Chourmouzi Danai, Hytiroglou Prodromos, Drevelegas Konstantinos, Constantinides Manos, Drevelegas Antonios, Talwalkar Jayant, Akriviadis Evangelos
4 Internal Medicine Unit, University of Thessaloniki (Lavrentios Papalavrentios, Emmanouil Sinakos, Evangelos Akriviadis), Greece.
Department of Radiology, Interbalkan Medical Center, Thessaloniki (Danai Chourmouzi, Konstantinos Drevelegas, Manos Constantinides, Antonios Drevelegas), Greece.
Ann Gastroenterol. 2015 Jan-Mar;28(1):118-123.
Limited data are available regarding the role of magnetic resonance imaging (MRI), particularly the new generation 3 Tesla technology, and especially diffusion-weighted imaging (DWI) in predicting liver fibrosis. The aim of our pilot study was to assess the clinical performance of the apparent diffusion coefficient (ADC) of liver parenchyma for the assessment of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).
18 patients with biopsy-proven NAFLD underwent DWI with 3 Tesla MRI. DWI was performed with single-shot echo-planar technique at b values of 0-500 and 0-1000 s/mm. ADC was measured in four locations in the liver and the mean ADC value was used for analysis. Staging of fibrosis was performed according to the METAVIR system.
The median age of patients was 52 years (range 23-73). The distribution of patients in different fibrosis stages was: 0 (n=1), 1 (n=7), 2 (n=1), 3 (n=5), 4 (n=4). Fibrosis stage was poorly associated with ADC at b value of 0-500 s/mm (r= -0.30, P=0.27). However it was significantly associated with ADC at b value of 0-1000 s/mm (r= -0.57, P=0.01). For this b value (0-1000 s/mm) the area under receiver-operating characteristic curve was 0.93 for fibrosis stage ≥3 and the optimal ADC cut-off value was 1.16 ×10 mm/s.
3 Tesla DWI can possibly predict the presence of advanced fibrosis in patients with NAFLD.
关于磁共振成像（MRI），尤其是新一代3特斯拉技术，特别是扩散加权成像（DWI）在预测肝纤维化中的作用，现有数据有限。我们的初步研究目的是评估肝实质表观扩散系数（ADC）在非酒精性脂肪性肝病（NAFLD）患者肝纤维化评估中的临床性能。
18例经活检证实为NAFLD的患者接受了3特斯拉MRI的DWI检查。采用单次激发回波平面技术在b值为0 - 500和0 - 1000 s/mm²时进行DWI检查。在肝脏的四个位置测量ADC，并使用平均ADC值进行分析。根据METAVIR系统进行纤维化分期。
患者的中位年龄为52岁（范围23 - 73岁）。不同纤维化阶段患者的分布为：0期（n = 1），1期（n = 7），2期（n = 1），3期（n = 5），4期（n = 4）。在b值为0 - 500 s/mm²时，纤维化阶段与ADC的相关性较差（r = -0.30，P = 0.27）。然而，在b值为0 - 1000 s/mm²时，它与ADC显著相关（r = -0.57，P = 0.01）。对于该b值（0 - 1000 s/mm²），纤维化阶段≥3时的受试者操作特征曲线下面积为0.93，最佳ADC临界值为1.16×10⁻³ mm²/s。
3特斯拉DWI可能有助于预测NAFLD患者是否存在晚期纤维化。
