Surov Alexey, Paul Lisa, Meyer Hans Jonas, Schob Stefan, Engelmann Cornelius, Wienke Andreas
Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
Section Hepatology, Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
J Clin Med. 2018 Oct 15;7(10):359. doi: 10.3390/jcm7100359.
Diffusion weighted imaging can provide information regarding tissue composition and can quantitatively characterize different pathological changes by means of apparent diffusion coefficient (ADC). The study comprised of 114 patients with liver cirrhosis-22 women and 92 men with a mean age of 56.5 ± 9.0 years. In all patients, the Model for End Stage-Liver Disease (MELD) score was calculated. Furthermore, 12 healthy persons (5 women, 7 men), mean age, 42.1 ± 16.2 years, were investigated as a control group. In all cases, magnetic resonance imaging of the liver/trunk was performed using different 3T scanners and diffusion weighted images were obtained with a multi-shot SE-EPI sequence. In all cases, polygonal regions of interest were manually drawn on the ADC maps along the contours of the iliopsoas and paravertebral muscles. The comparison of ADC values in groups was performed by Mann-Whitney-U tests. The association between ADC and MELD score was calculated by Spearman's rank correlation coefficient. ADC values of the skeletal musculature were statistically much higher in comparison to those in the control group: 1.85 ± 0.46 × 10 mm² s vs. 1.23 ± 0.12 × 10 mm² s, = 0.001. ADC values showed statistically significant correlation with the MELD score ( = 0.473, = 0.0001). Furthermore, ADC values differed between the subgroups with different values of the MELD score. ADC values correlated slightly with lactate dehydrogenase (LDH) ( = 0.381, = 0.0001) and tended to correlate with C-reactive protein (CRP) ( = 0.171, = 0.07) and alanine aminotransferase (ALAT) ( = -0.167, = 0.076). ADC can reflect muscle changes in liver cirrhosis and shows statistically significant correlation with the MELD score. Therefore, ADC can be used as an imaging biomarker of myopathic changes in liver cirrhosis.
扩散加权成像可以提供有关组织成分的信息，并可以通过表观扩散系数（ADC）对不同的病理变化进行定量表征。该研究纳入了114例肝硬化患者，其中22例女性，92例男性，平均年龄为56.5±9.0岁。对所有患者计算终末期肝病模型（MELD）评分。此外，调查了12名健康人（5名女性，7名男性）作为对照组，平均年龄为42.1±16.2岁。在所有病例中，使用不同的3T扫描仪对肝脏/躯干进行磁共振成像，并通过多次激发SE-EPI序列获得扩散加权图像。在所有病例中，在ADC图上沿着髂腰肌和椎旁肌的轮廓手动绘制多边形感兴趣区域。通过Mann-Whitney-U检验对各组的ADC值进行比较。通过Spearman等级相关系数计算ADC与MELD评分之间的相关性。与对照组相比，骨骼肌的ADC值在统计学上显著更高：1.85±0.46×10⁻³mm²/s对1.23±0.12×10⁻³mm²/s，P = 0.001。ADC值与MELD评分在统计学上具有显著相关性（r = 0.473，P = 0.0001）。此外，不同MELD评分值的亚组之间ADC值存在差异。ADC值与乳酸脱氢酶（LDH）轻度相关（r = 0.381，P = 0.0001），并倾向于与C反应蛋白（CRP）相关（r = 0.171，P = 0.07）和丙氨酸转氨酶（ALAT）相关（r = -0.167，P = 0.076）。ADC可以反映肝硬化中的肌肉变化，并与MELD评分在统计学上具有显著相关性。因此，ADC可作为肝硬化肌病性改变的影像学生物标志物。
