Department of Radiological Technology, Toranomon Hospital, Tokyo, Japan.
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
Gut Liver. 2017 Sep 15;11(5):674-683. doi: 10.5009/gnl16440.
BACKGROUND/AIMS: Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the hepatic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD.
A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diagnosing fibrosis ≥F3-4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify variables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio.
The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confidence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associated with the L/R ratio (coefficient, 0.121; p<0.0001).
The L/R ratio, which is not influenced by pathological parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD.
背景/目的：对非酒精性脂肪性肝病（NAFLD）患者进行了非侵入性肝纤维化评估。我们使用了一种基于钆塞酸二钠增强（Gd-EOB-DTPA 增强）磁共振成像（MRI）获得的肝体积的定量方法，用于诊断 NAFLD 患者的晚期纤维化。
共回顾性纳入了 130 例诊断为 NAFLD 并接受 Gd-EOB-DTPA 增强 MRI 的患者。118 例患者有组织学数据。测量了肝体积参数，包括左肝叶与右肝叶的体积比（L/R 比）。使用受试者工作特征（ROC）曲线下面积（AUROC）评估 L/R 比诊断纤维化≥F3-4 和 F4 的有效性。进行了多元回归分析，以确定与 L/R 比相关的变量（年龄、体重指数、血清纤维化标志物和组织学特征）。
L/R 比在区分晚期纤维化（AUROC，0.80；95%置信区间，0.72 至 0.88）和肝硬化（AUROC，0.87；95%置信区间，0.75 至 0.99）方面表现出良好的性能。多元回归分析显示，只有纤维化与 L/R 比显著相关（系数，0.121；p<0.0001）。
L/R 比不受纤维化以外的病理参数影响，可用于诊断 NAFLD 患者的肝硬化。
