Hennedige Tiffany P, Wang Gang, Leung Fiona P, Alsaif Hind S, Teo Lynette Ls, Lim Seng Gee, Wee Aileen, Venkatesh Sudhakar K
Department of Diagnostic Imaging, National University of Singapore, Singapore.
Department of Biomedical Engineering, University of Calgary, Calgary, Canada.
Gut Liver. 2017 May 15;11(3):401-408. doi: 10.5009/gnl16079.
BACKGROUND/AIMS: Comparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).
In this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWI-BH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC.
There was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH.
MRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.
背景/目的：比较磁共振弹性成像（MRE）和扩散加权成像（DWI）对慢性乙型肝炎（CHB）患者肝纤维化的诊断准确性。
在这项回顾性分析中，我们研究了63例CHB和肝纤维化患者。采用屏气（DWI-BH）和自由呼吸（DWI-FB）序列（b = 0, 500）进行DWI检查。通过绘制感兴趣区图计算肝脏平均硬度和表观扩散系数（ADC）。由经验丰富的病理学家独立进行基于METAVIR系统的纤维化分期。进行受试者操作特征曲线（ROC）分析，以确定MRE、DWI-BH和DWI-FB在肝纤维化检测和分层中的准确性。还通过比较ROC曲线下面积评估显著纤维化（≥F2）、进展性纤维化（≥F3）和肝硬化（F4）的检测性能。
ADC值与肝脏硬度之间存在中度且显著的负相关。DWI-FB、DWI-BH和MRE检测≥F2/≥F3/F4期纤维化的准确率分别为0.84/0.76/0.72、0.72/0.83/0.79和0.99/0.99/0.98。MRE的性能显著优于DWI-FB和DWI-BH。DWI-FB和DWI-BH的性能之间无显著差异。
在CHB患者肝纤维化的检测和分层方面，MRE比DWI更准确。
