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钆塞酸二钠增强 MRI 检测肝纤维化:一项确证性研究。

Detecting liver fibrosis with Gd-EOB-DTPA-enhanced MRI: A confirmatory study.

机构信息

Department of Radiology, University Hospital Regensburg, Regensburg, Germany.

Department of Pathology, University Regensburg, Regensburg, Germany.

出版信息

Sci Rep. 2018 Apr 18;8(1):6207. doi: 10.1038/s41598-018-24316-z.

Abstract

Strong correlations between the grade of fibrosis and cirrhosis, classified using the Ishak scoring system, and the uptake characteristics of Gd-EOB-DTPA with the relative enhancement (RE) of the liver parenchyma have been reported. To confirm the results of a retrospective analysis, patients undergoing liver surgery were prospectively examined with Gd-EOB-DTPA-enhanced liver 3 Tesla MRI to determine the degree of liver fibrosis. Correlations between the grade of fibrosis and cirrhosis, classified using the Ishak scoring system, and RE were investigated and compared with those derived from an initial retrospective study. After validating the cut-off values in the retrospective study (Ishak ≥ 1, RE-cut-off 0.90; Ishak ≥ 2, RE-cut-off 0.79; Ishak ≥ 4, RE-cut-off 0.60; and Ishak = 6, RE-cut-off 0.47), we showed that Gd-EOB-DTPA has a high sensitivity (≥86%) and a high positive predictive value (≥86%). These results support the use of Gd-EOB-DTPA-enhanced liver MRI as a non-invasive method for determining the degree of liver fibrosis and cirrhosis.

摘要

已有研究报道,纤维化和肝硬化的分级(采用 Ishak 评分系统)与钆塞酸二钠(Gd-EOB-DTPA)的摄取特征(肝脏实质的相对增强率(RE))之间存在很强的相关性。为了确认回顾性分析的结果,前瞻性地对接受肝脏手术的患者进行了 Gd-EOB-DTPA 增强肝脏 3T MRI 检查,以确定肝脏纤维化的程度。研究分析了纤维化和肝硬化的分级(采用 Ishak 评分系统)与 RE 之间的相关性,并与初始回顾性研究的结果进行了比较。在验证了回顾性研究中的截断值(Ishak≥1,RE 截断值 0.90;Ishak≥2,RE 截断值 0.79;Ishak≥4,RE 截断值 0.60;Ishak=6,RE 截断值 0.47)后,我们发现 Gd-EOB-DTPA 具有较高的灵敏度(≥86%)和较高的阳性预测值(≥86%)。这些结果支持使用 Gd-EOB-DTPA 增强肝脏 MRI 作为一种非侵入性方法来确定肝脏纤维化和肝硬化的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e52/5906481/9139ffe4f2b9/41598_2018_24316_Fig1_HTML.jpg

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