Department of Radiology, University of Yamanashi, Yamanashi, Japan.
Diagnostic Radiology, Saitama Medical University International Medical Center, Saitama, Japan.
J Magn Reson Imaging. 2018 May;47(5):1268-1275. doi: 10.1002/jmri.25868. Epub 2017 Oct 14.
Liver MR elastography (MRE) is available for the noninvasive assessment of liver fibrosis; however, no previous studies have compared the diagnostic ability of MRE with that of liver biopsy.
To compare the diagnostic accuracy of liver fibrosis staging between MRE-based methods and liver biopsy using the resected liver specimens as the reference standard.
A retrospective study at a single institution.
In all, 200 patients who underwent preoperative MRE and subsequent surgical liver resection were included in this study. Data from 80 patients were used to estimate cutoff and distributions of liver stiffness values measured by MRE for each liver fibrosis stage (F0-F4, METAVIR system). In the remaining 120 patients, liver biopsy specimens were obtained from the resected liver tissues using a standard biopsy needle.
FIELD STRENGTH/SEQUENCE: 2D liver MRE with gradient-echo based sequence on a 1.5 or 3T scanner was used.
Two radiologists independently measured the liver stiffness value on MRE and two types of MRE-based methods (threshold and Bayesian prediction method) were applied. Two pathologists evaluated all biopsy samples independently to stage liver fibrosis. Surgically resected whole tissue specimens were used as the reference standard.
The accuracy for liver fibrosis staging was compared between liver biopsy and MRE-based methods with a modified McNemar's test.
Accurate fibrosis staging was achieved in 53.3% (64/120) and 59.1% (71/120) of patients using MRE with threshold and Bayesian methods, respectively, and in 51.6% (62/120) with liver biopsy. Accuracies of MRE-based methods for diagnoses of ≥F2 (90-91% [108-9/120]), ≥F3 (79-81% [95-97/120]), and F4 (82-85% [98-102/120]) were statistically equivalent to those of liver biopsy (≥F2, 79% [95/120], P ≤ 0.01; ≥F3, 88% [105/120], P ≤ 0.006; and F4, 82% [99/120], P ≤ 0.017).
MRE can be an alternative to liver biopsy for fibrosis staging.
肝脏磁共振弹性成像（MRE）可用于无创评估肝纤维化；然而，尚无研究比较 MRE 与肝活检在诊断肝纤维化方面的诊断能力。
比较 MRE 与肝活检在以切除肝组织为参考标准的肝纤维化分期中的诊断准确性。
单中心回顾性研究。
本研究共纳入 200 例接受术前 MRE 及随后手术肝切除的患者。80 例患者的数据用于估计 MRE 测量的肝脏硬度值在每个肝纤维化分期（METAVIR 系统的 F0-F4）的截断值和分布。在其余 120 例患者中，使用标准活检针从切除的肝组织中获得肝活检标本。
磁场强度/序列：使用基于梯度回波的二维肝脏 MRE，在 1.5 或 3T 扫描仪上进行。
两名放射科医生独立测量 MRE 上的肝脏硬度值，并应用两种基于 MRE 的方法（阈值和贝叶斯预测方法）。两名病理学家独立评估所有活检样本以分期肝纤维化。手术切除的整个组织标本用作参考标准。
采用修正的 McNemar 检验比较肝活检与基于 MRE 的方法在肝纤维化分期中的准确性。
使用基于阈值和贝叶斯方法的 MRE 分别准确分期 53.3%（64/120）和 59.1%（71/120）的患者，而肝活检的准确率为 51.6%（62/120）。MRE 对≥F2（90-91%[108-9/120]）、≥F3（79-81%[95-97/120]）和 F4（82-85%[98-102/120]）的诊断准确性与肝活检相当（≥F2，79%[95/120]，P ≤ 0.01；≥F3，88%[105/120]，P ≤ 0.006；F4，82%[99/120]，P ≤ 0.017）。
MRE 可作为肝活检的替代方法用于纤维化分期。
Zotero 插件