Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People's Republic of China.
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Abdom Radiol (NY). 2019 Apr;44(4):1407-1414. doi: 10.1007/s00261-018-1860-1.
To evaluate the value of MR liver extracellular volume (ECV) in assessment of liver fibrosis with chronic hepatitis B (CHB), and to compare its performance with two-dimensional (2D) shear-wave elastography (SWE).
A total of 68 CHB patients who were histologically diagnosed as fibrosis stages F0 to F4 were retrospectively analyzed. All patients underwent gadopentetate dimeglumine-enhanced T1-mapping and 2D SWE. ECV and liver stiffness were measured and compared between fibrosis subgroups; their correlations with histologic findings were evaluated using Spearman correlation test and multiple regression analysis. Diagnostic performance in evaluating liver fibrosis stages was assessed and compared using receiver-operating characteristic analysis.
Both ECV and liver stiffness increased as the fibrosis score increased (F = 17.08 to 10.99, P < 0.001). ECV displayed a strong correlation with fibrosis stage (r = 0.740, P < 0.001), and liver stiffness displayed a moderate correlation (r = 0.651, P < 0.001); multivariate analysis revealed that only ECV was independently correlated with fibrosis stage (P < 0.001). Univariate analyses showed significant correlations of ECV with fibrosis stage, inflammatory activity, and platelet count; among all, the fibrosis stage had the highest correlation coefficient and was the only independent factor (P < 0.001). Overall, ECV had no significant different performance compared with 2D SWE for the identification of both fibrosis stage s ≥ F2 and F4 (P = 0.868 and 0.171).
MR ECV plays a promising role in the prediction of liver fibrosis for patients with CHB, comparable to 2D SWE.
评估磁共振肝脏细胞外容积（ECV）评估慢性乙型肝炎（CHB）患者肝纤维化的价值，并与二维剪切波弹性成像（2D SWE）进行比较。
回顾性分析 68 例经组织学诊断为纤维化分期 F0 至 F4 的 CHB 患者。所有患者均接受钆喷替酸葡甲胺增强 T1 映射和 2D SWE 检查。测量并比较纤维化亚组之间的 ECV 和肝硬度；使用 Spearman 相关检验和多元回归分析评估与组织学发现的相关性。使用受试者工作特征分析评估并比较评估肝纤维化分期的诊断性能。
ECV 和肝硬度随纤维化评分的增加而增加（F=17.08 至 10.99，P<0.001）。ECV 与纤维化分期呈强相关（r=0.740，P<0.001），肝硬度呈中度相关（r=0.651，P<0.001）；多变量分析显示，只有 ECV 与纤维化分期独立相关（P<0.001）。单因素分析显示，ECV 与纤维化分期、炎症活动度和血小板计数均显著相关；其中，纤维化分期的相关性系数最高，且为唯一独立因素（P<0.001）。总体而言，ECV 在鉴别纤维化分期≥F2 和 F4 方面与 2D SWE 的性能无显著差异（P=0.868 和 0.171）。
MR ECV 在预测 CHB 患者肝纤维化方面具有良好的应用前景，与 2D SWE 相当。
