Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, United States.
Eur Radiol. 2020 Mar;30(3):1719-1729. doi: 10.1007/s00330-019-06471-7. Epub 2019 Nov 11.
To determine the diagnostic performance, cut-off values, and optimal drive frequency range for staging hepatic fibrosis using tomoelastography by multifrequency MR elastography of the liver and spleen.
This prospective study consecutively enrolled a total of 61 subjects between June 2014 and April 2017: 45 patients with chronic liver disease and proven stage of fibrosis and 16 healthy volunteers. Tomoelastography was performed at 1.5 T using six drive frequencies from 35 to 60 Hz. Cut-off values and AUC were calculated. Shear wave speed (in m/s) of the liver and spleen was assessed separately and in combination as a surrogate of stiffness.
For compound multifrequency processing of the liver, cut-off and AUC values by fibrosis stage were as follows: F1, 1.52 m/s and 0.89; F2, 1.55 m/s and 0.94; F3, 1.67 m/s and 0.98; and F4, 1.72 m/s and 0.98. Diagnostic performance of the best single drive frequencies (45 Hz, 55 Hz, 60 Hz) was similar (mean AUC = 0.95, respectively). Combined analysis of the liver and spleen slightly improved performance at 60 Hz in F4 patients (mean AUC = 0.97 vs. 0.95, p = 0.03). Full-field-of-view elastograms displayed not only the liver and spleen but also small anatomical structures including the pancreas and major vessels.
Tomoelastography provides full-field-of-view elastograms with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis. Our analysis of single-frequency tomoelastography suggests that scan time can be further reduced in future studies, making tomoelastography easier to implement in clinical routine.
• Tomoelastography provides full-field-of-view elastograms of the abdomen with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis. • Diagnostic performance of single-frequency tomoelastography at higher frequencies (45 Hz, 55 Hz, 60 Hz) and compound multifrequency processing are equivalent for staging hepatic fibrosis. • Combined assessment of hepatic and splenic stiffness slightly improves diagnostic performance for staging hepatic fibrosis.
通过多频磁共振弹性成像中的断层弹性成像技术，确定肝脏和脾脏多频磁共振弹性成像技术诊断肝纤维化分期的诊断性能、临界值和最佳驱动频率范围。
本前瞻性研究连续纳入了 2014 年 6 月至 2017 年 4 月间共 61 名受试者：45 名慢性肝病患者和已证实的纤维化分期患者，以及 16 名健康志愿者。在 1.5T 下使用 35 至 60Hz 的六个驱动频率进行断层弹性成像。计算出临界值和 AUC。分别评估肝脏和脾脏的剪切波速度（m/s），并将其作为硬度的替代物进行组合评估。
对于肝脏的复合多频处理，按纤维化分期的截断值和 AUC 值如下：F1，1.52m/s 和 0.89；F2，1.55m/s 和 0.94；F3，1.67m/s 和 0.98；F4，1.72m/s 和 0.98。最佳单驱动频率（45Hz、55Hz、60Hz）的诊断性能相似（平均 AUC 分别为 0.95）。在 F4 患者中，对肝脏和脾脏的联合分析在 60Hz 时略微提高了性能（平均 AUC=0.97 比 0.95，p=0.03）。全视野弹性成像不仅能显示肝脏和脾脏，还能显示包括胰腺和大血管在内的小解剖结构。
断层弹性成像提供了具有前所未有的细节分辨率和出色诊断准确性的全视野弹性图像，用于肝纤维化分期。我们对单频断层弹性成像的分析表明，在未来的研究中可以进一步减少扫描时间，使断层弹性成像更容易在临床常规中实施。
断层弹性成像提供了具有前所未有的细节分辨率和出色诊断准确性的全视野腹部弹性图像，用于肝纤维化分期。
较高频率（45Hz、55Hz、60Hz）的单频断层弹性成像和复合多频处理的诊断性能对肝纤维化分期等效。
对肝脾硬度的联合评估略微提高了肝纤维化分期的诊断性能。
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