Sheng R F, Jin K P, Wang H Q, Ji Y, Chen C Z, Zeng M S
Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai 200032, China.
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Gan Zang Bing Za Zhi. 2018 Sep 20;26(9):650-653. doi: 10.3760/cma.j.issn.1007-3418.2018.09.003.
To investigate the diagnostic value of extracellular volume (ECV) imaging by magnetic resonance imaging for liver fibrosis of hepatitis B. A retrospective analysis was recruited in patients with chronic hepatitis B, who underwent liver surgery from April to October 2017 for pathological evaluation of liver tissues, and all patients underwent Gd-EOB-DTPA-enhanced T1 mapping to calculate the liver ECV score. The correlation between ECV and staging of hepatic fibrosis and inflammatory activity were compared to clarify the diagnostic value of staging of fibrosis. 66 patients were enrolled in this study. Concerning the staging of liver fibrosis, there were 13, 4, 13, 10, and 26 cases with F0, F1, F2, F3 and F4 stages, respectively. ECV values had high interobserver consistency (correlation coefficient 0.860). The ECV difference between different stages of liver fibrosis was statistically significant ( = 15.02, < 0.001). There was a significant positive correlation between ECV and fibrosis stage ( = 0.622, < 0.001), and weak correlation with inflammatory activity ( = 0.332, = 0.007). Fibrosis staging was an independent factor influencing ECV ( < 0.001). The area under the receiver operator characteristic curve for the diagnosis of liver fibrosis staging F≥1, F≥3 and F4 were 0.760, 0.846 and 0.873, respectively. The diagnostic sensitivity and specificity were 64.15%, 92.31%, 77.78%, 80.00% and 88.46, 72.50%, respectively. MRI-ECV imaging has great value for staging hepatic fibrosis of hepatitis B, and it can provide an effective method for diagnosis, staging, and evaluating the curative effect of fibrosis.
探讨磁共振成像细胞外容积(ECV)成像对乙型肝炎肝纤维化的诊断价值。对2017年4月至10月因肝组织病理评估接受肝脏手术的慢性乙型肝炎患者进行回顾性分析,所有患者均接受钆塞酸二钠增强T1mapping以计算肝脏ECV评分。比较ECV与肝纤维化分期及炎症活动度的相关性,以明确纤维化分期的诊断价值。本研究共纳入66例患者。关于肝纤维化分期,F0、F1、F2、F3和F4期分别有13例、4例、13例、10例和26例。ECV值具有较高的观察者间一致性(相关系数0.860)。肝纤维化不同分期之间的ECV差异具有统计学意义( = 15.02, < 0.001)。ECV与纤维化分期呈显著正相关( = 0.622, < 0.001),与炎症活动度呈弱相关( = 0.332, = 0.007)。纤维化分期是影响ECV的独立因素( < 0.001)。诊断肝纤维化分期F≥1、F≥3和F4的受试者操作特征曲线下面积分别为0.760、0.846和0.873。诊断敏感性和特异性分别为64.15%、92.31%、77.78%、80.00%和88.46%、72.50%。MRI-ECV成像对乙型肝炎肝纤维化分期具有重要价值,可为纤维化的诊断、分期及疗效评估提供有效方法。