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磁共振弹性成像在肝纤维化评估中的应用:一项比较瞬时弹性成像和组织学数据的研究,该研究在同一批患者中进行。

Magnetic resonance elastography in the assessment of hepatic fibrosis: a study comparing transient elastography and histological data in the same patients.

机构信息

Department of Radiology, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan.

出版信息

Abdom Radiol (NY). 2017 Jun;42(6):1659-1666. doi: 10.1007/s00261-017-1045-3.

Abstract

PURPOSE

To evaluate the quantitative measurement of liver stiffness (LS), compare the diagnostic performance of magnetic resonance elastography (MRE) and ultrasound-based transient elastography (TE), and evaluate two different MRE-based LS measurement methods.

METHODS

Between October 2013 and January 2015, 116 consecutive patients with chronic liver disease underwent MRE to measure LS (kilopascals; kPa). Of the 116 patients, 51 patients underwent both TE and liver biopsy, and the interval between the liver biopsy and both the MRE and TE was less than 90 days. MRE-derived LS values were measured on the anterior segment of the right lobe (single small round regions of interest per slice; srROIs) and whole right lobe of the liver (free hand region of interest; fhROI), and these values were correlated with pathological fibrosis grades and diagnostic performance.

RESULTS

Pathological fibrosis stage was significantly correlated with srROIs (r = 0.87, p < 0.001), fhROI (r = 0.80, p < 0.001), and TE (r = 0.73, p < 0.001). For detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis, the area under the curve (AUC) associated with the srROIs was largest, and there was a significant difference between srROIs and TE (0.93 vs. 0.82, p = 0.006), srROIs and fhROI (0.93 vs. 0.89, p = 0.04) for detection of ≥F2. For advanced fibrosis and cirrhosis detection, AUCs were not significant (0.92-0.96).

CONCLUSIONS

MRE and TE detected liver fibrosis with comparable accuracy. In particular, the srROIs method was effective for detecting of significant fibrosis.

摘要

目的

评估肝脏硬度的定量测量,比较磁共振弹性成像(MRE)和基于超声的瞬时弹性成像(TE)的诊断性能,并评估两种不同的基于 MRE 的 LS 测量方法。

方法

在 2013 年 10 月至 2015 年 1 月期间,对 116 例慢性肝病患者进行 MRE 测量 LS(千帕斯卡;kPa)。在这 116 例患者中,有 51 例患者同时接受了 TE 和肝活检,肝活检与 MRE 和 TE 的间隔时间小于 90 天。MRE 衍生的 LS 值是在右叶前节(每片一个小圆形感兴趣区;srROIs)和整个右肝(自由手感兴趣区;fhROI)上测量的,这些值与病理纤维化程度和诊断性能相关。

结果

病理纤维化分期与 srROIs(r=0.87,p<0.001)、fhROI(r=0.80,p<0.001)和 TE(r=0.73,p<0.001)显著相关。对于检测显著纤维化(≥F2)、进展性纤维化(≥F3)和肝硬化,srROIs 的曲线下面积(AUC)最大,srROIs 与 TE(0.93 与 0.82,p=0.006)、srROIs 与 fhROI(0.93 与 0.89,p=0.04)之间存在显著差异,用于检测≥F2。对于进展性纤维化和肝硬化的检测,AUC 无显著差异(0.92-0.96)。

结论

MRE 和 TE 检测肝纤维化的准确性相当。特别是,srROIs 方法对于检测显著纤维化是有效的。

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