Venkatesh Sudhakar K, Hoodeshenas Safa, Venkatesh Sandeep H, Dispenzieri Angela, Gertz Morie A, Torbenson Michael S, Ehman Richard L
Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Department of Radiology, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore.
J Clin Med. 2019 May 23;8(5):739. doi: 10.3390/jcm8050739.
In this paper, we present our preliminary findings regarding magnetic resonance elastography (MRE) on the livers of 10 patients with systemic amyloidosis. Mean liver stiffness measurements (LSM) and spleen stiffness measurements (SSM) were obtained. Magnetic resonance imaging (MRI) images were analyzed for the distribution pattern of amyloid deposition. Pearson correlation analysis was performed in order to study the correlation between LSM, SSM, liver span, liver volume, spleen span, spleen volume, serum alkaline phosphatase (ALP), N-terminal pro b-type natriuretic peptide (NT pro BNP), and the kappa and lambda free light chains. An increase in mean LSM was seen in all patients. Pearson correlation analysis showed a statistically significant correlation between LSM and liver volume ( = 0.78, = 0.007) and kappa chain level ( = 0.65, = 0.04). Interestingly, LSM did not correlate significantly with SSM ( = 0.45, = 0.18), liver span ( = 0.57, = 0.08), or serum ALP ( = 0.60, = 0.07). However, LSM correlated significantly with serum ALP when corrected for liver volume (partial correlation, = 0.71, = 0.03) and NT pro BNP levels (partial correlation, = 0.68, = 0.04). MRI review revealed that amyloid deposition in the liver can be diffuse, lobar, or focal. MRE is useful for the evaluation of hepatic amyloidosis and shows increased stiffness in hepatic amyloidosis. MRE has the potential to be a non-invasive quantitative imaging marker for hepatic amyloidosis.
在本文中,我们展示了关于10例系统性淀粉样变性患者肝脏的磁共振弹性成像(MRE)的初步研究结果。获得了平均肝脏硬度测量值(LSM)和脾脏硬度测量值(SSM)。对磁共振成像(MRI)图像进行分析以观察淀粉样蛋白沉积的分布模式。进行Pearson相关性分析以研究LSM、SSM、肝径、肝脏体积、脾径、脾脏体积、血清碱性磷酸酶(ALP)、N末端B型利钠肽原(NT pro BNP)以及κ和λ游离轻链之间的相关性。所有患者的平均LSM均升高。Pearson相关性分析显示LSM与肝脏体积(r = 0.78,P = 0.007)和κ链水平(r = 0.65,P = 0.04)之间存在统计学显著相关性。有趣的是,LSM与SSM(r = 0.45,P = 0.18)、肝径(r = 0.57,P = 0.08)或血清ALP(r = 0.60,P = 0.07)无显著相关性。然而,在校正肝脏体积后LSM与血清ALP显著相关(偏相关性,r = 0.71,P = 0.03),与NT pro BNP水平也显著相关(偏相关性,r = 0.68, P = 0.04)。MRI检查显示肝脏中的淀粉样蛋白沉积可以是弥漫性、叶性或局灶性的。MRE有助于评估肝脏淀粉样变性,并且显示在肝脏淀粉样变性中硬度增加。MRE有可能成为肝脏淀粉样变性的一种非侵入性定量成像标志物。