Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea.
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Eur Radiol. 2018 Aug;28(8):3513-3521. doi: 10.1007/s00330-017-5278-x. Epub 2018 Feb 27.
To retrospectively evaluate the prognostic role of liver stiffness (LS) measurement using magnetic resonance elastography (MRE) in patients with compensated chronic liver disease (cCLD).
We enrolled 217 patients with cCLD who underwent MRE. After mean follow-up of 45.0 ± 17.6 months, cumulative incidence (CI) of hepatocellular carcinoma (HCC) occurrence, development of decompensation and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazard regression model.
During the follow-up period, HCC occurred in 33 patients, and 1-, 3- and 5-year CIs of HCC occurrence were 3.8%, 14.8% and 18.9%, respectively. The LS value was a significant predictive factor for HCC occurrence [p < 0.001, hazard ratio (HR) = 1.59 per unit (1.25-2.03)]. Eighteen patients experienced hepatic decompensation, and 1-, 3- and 5-year CIs of decompensation were 2.8%, 7.3% and 11.3%, respectively. The LS value was also significantly associated with decompensation development [p < 0.001, HR = 2.02 per unit (1.37-2.98)]. Fourteen patients died, and 1-, 3- and 5-year OSs were 99.1%, 98.0% and 89.8%, respectively. The LS value was demonstrated to be a significant affecting factor for OS [p = 0.008, HR = 1.39 per unit (1.10-1.78)].
LS obtained from MRE was a significant predictive factor for the development of decompensation, HCC occurrence and OS in cCLD patients.
• Liver stiffness (LS) values obtained from MRE can provide prognostic information. • The LS value was a significant predictive factor for occurrence of hepatocellular carcinoma. • The LS value was significantly associated with development of hepatic decompensation. • Survival of compensated chronic liver disease patients was affected by the LS value.
回顾性评估磁共振弹性成像(MRE)测量肝硬度(LS)在代偿性慢性肝病(cCLD)患者中的预后作用。
我们纳入了 217 例接受 MRE 检查的 cCLD 患者。经过平均 45.0±17.6 个月的随访后,采用 Kaplan-Meier 法估计肝细胞癌(HCC)发生、失代偿发展和总生存(OS)的累积发生率(CI)。采用 Cox 比例风险回归模型评估预后因素。
在随访期间,33 例患者发生 HCC,HCC 发生的 1、3 和 5 年 CI 分别为 3.8%、14.8%和 18.9%。LS 值是 HCC 发生的显著预测因素[P<0.001,风险比(HR)为每单位增加 1.59(1.25-2.03)]。18 例患者发生肝失代偿,失代偿的 1、3 和 5 年 CI 分别为 2.8%、7.3%和 11.3%。LS 值与失代偿发展显著相关[P<0.001,HR 为每单位增加 2.02(1.37-2.98)]。14 例患者死亡,1、3 和 5 年 OS 分别为 99.1%、98.0%和 89.8%。LS 值被证明是 OS 的显著影响因素[P=0.008,HR 为每单位增加 1.39(1.10-1.78)]。
MRE 获得的 LS 是 cCLD 患者发生失代偿、HCC 发生和 OS 的显著预测因素。