评估高级肝脏磁共振弹性成像方法在临床患者中的磁化率伪影抑制效果。
Assessment of advanced hepatic MR elastography methods for susceptibility artifact suppression in clinical patients.
机构信息
Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University (SYSU), Guangzhou, Guangdong, P.R China.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
J Magn Reson Imaging. 2018 Apr;47(4):976-987. doi: 10.1002/jmri.25818. Epub 2017 Aug 11.
PURPOSE
To assess the success rate, image quality, and the ability to stage liver fibrosis of a standard 2D gradient-recalled echo (GRE) and four different spin-echo (SE) magnetic resonance elastography (MRE) sequences in patients with different liver iron concentrations.
MATERIALS AND METHODS
A total of 332 patients who underwent 3T MRE examinations that included liver fat and iron quantification were enrolled, including 136 patients with all five MRE techniques. Thirty-four patients had biopsy results for fibrosis staging. The liver stiffness, region of interest area, image quality, and success rate of the five sequences were compared in 115/136 patients. The area under the receiver operating characteristic curves (AUCs) and the accuracies for diagnosing early-stage fibrosis and advanced fibrosis were compared. The effect of BMI (body mass index), the R2* relaxation time, and fat fraction on the image quality and liver stiffness measurements were analyzed.
RESULTS
The success rates were significantly higher in the four SE sequences (99.1-100%) compared with GRE MRE (85.3%) (all P < 0.001). There were significant differences of the mean ROI area between every pair of sequences (all P < 0.0001). There were no significant differences in the AUC of the five MRE sequences for discriminating advanced fibrosis (10 P-values ranging from 0.2410-0.9171). R2* had a significant effect on the success rate and image quality for the noniron 2D echo-planar imaging (EPI), 3D EPI and 2D GRE (all P < 0.001) sequences. BMI had a significant effect on the iron 2D EPI (P = 0.0230) and iron 2D SE (P = 0.0040) sequences.
CONCLUSION
All five techniques showed good diagnostic performance in staging liver fibrosis. The SE MRE sequences had higher success rates and better image quality than GRE MRE in 3T clinical hepatic imaging.
LEVEL OF EVIDENCE
3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:976-987.
目的
评估标准二维梯度回波（GRE）和四种不同的自旋回波（SE）磁共振弹性成像（MRE）序列在不同铁浓度的肝脏中的成功率、图像质量和肝纤维化分期能力。
材料与方法
共纳入 332 例接受 3T MRE 检查的患者，包括肝脏脂肪和铁定量，其中 136 例患者接受了所有 5 种 MRE 技术检查。34 例患者进行了纤维化分期的活检。比较了 115/136 例患者的 5 种序列的肝脏硬度、感兴趣区面积、图像质量和成功率。比较了受试者工作特征曲线下面积（AUC）和诊断早期纤维化和晚期纤维化的准确性。分析了体重指数（BMI）、R2*弛豫时间和脂肪分数对图像质量和肝脏硬度测量的影响。
结果
与 GRE MRE（85.3%）相比，四种 SE 序列（99.1-100%）的成功率明显更高（均 P<0.001）。每对序列之间的平均 ROI 面积均有显著差异（均 P<0.0001）。五种 MRE 序列鉴别晚期纤维化的 AUC 无显著差异（10 个 P 值范围为 0.2410-0.9171）。R2*对非铁二维平面回波成像（EPI）、3D EPI 和 2D GRE 序列的成功率和图像质量有显著影响（均 P<0.001）。BMI 对铁二维 EPI（P=0.0230）和铁二维 SE（P=0.0040）序列有显著影响。
结论
所有五种技术在肝纤维化分期中均显示出良好的诊断性能。在 3T 临床肝脏成像中，SE MRE 序列比 GRE MRE 序列具有更高的成功率和更好的图像质量。
证据水平
3 技术疗效：5 级
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