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用 MRI 定量检测慢性肝病患者肝脏和胰腺的脂肪变性。

Quantifying steatosis in the liver and pancreas with MRI in patient with chronic liver disease.

机构信息

Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidad de Oporto, Oporto, Portugal.

Departamento de Diagnóstico por la Imagen, Centro Hospitalar do Porto, Oporto, Portugal; Escola de Medicina, Universidade do Minho, Braga, Portugal; ICVS/3B's, Instituto de Investigación de Ciencias de la Vida y la Salud, Universidade do Minho, Braga, Portugal.

出版信息

Radiologia (Engl Ed). 2020 May-Jun;62(3):222-228. doi: 10.1016/j.rx.2019.11.007. Epub 2020 Jan 10.

Abstract

AIM

To compare pancreatic and hepatic steatosis quantified by proton density fat fraction (PDFF) on magnetic resonance imaging (MRI) in patients with chronic liver disease.

MATERIAL AND METHODS

This cross-sectional study included 46 adult patients who underwent liver biopsy for chronic viral hepatitis (n=19) or other chronic non-alcoholic liver diseases (NALD) (n=27). Liver biopsy was used as the gold standard for diagnosing and grading hepatic steatosis. All patients underwent clinical evaluation and MRI with a multi-echo chemical shift-encoded (MECSE) gradient-echo sequence for liver and pancreas PDFF quantification. We used Spearman's correlation coefficient to determine the degree of association between hepatic PDFF and steatosis grade, and between pancreatic PDFF and steatosis grade and hepatic PDFF. To compare the chronic viral hepatitis group and the NALD group, we used t-tests for continuous or ordinal variables and chi-square tests for categorical variables.

RESULTS

Hepatic PDFF measurements correlated with steatosis grades (R=0.875, p<0.001). Pancreatic PDFF correlated with hepatic steatosis grades (R=0.573, p<0.001) and hepatic PDFF measurements (R=0.536, p<0.001). In the subgroup of patients with chronic NALD, the correlations remained significant between pancreatic PDFF and hepatic PDFF (R=0.632, p<0.001) and between pancreatic PDFF and liver steatosis (R=0.608, p<0.001); however, in the subgroup of patients with viral hepatitis these correlations were no longer significant.

CONCLUSION

Pancreatic fat deposition correlates with hepatic steatosis in patients with chronic NALD, but not in those with chronic viral hepatitis.

摘要

目的

比较磁共振成像(MRI)质子密度脂肪分数(PDFF)定量检测慢性肝病患者胰腺和肝脏脂肪变性的情况。

材料与方法

本横断面研究纳入了 46 例接受肝活检的成年慢性病毒性肝炎(n=19)或其他慢性非酒精性肝病(NALD)患者(n=27)。肝活检是诊断和分级肝脂肪变性的金标准。所有患者均接受临床评估和肝脏及胰腺 PDFF 定量的多回波化学位移编码(MECSE)梯度回波序列 MRI 检查。我们使用 Spearman 相关系数来确定肝 PDFF 与脂肪变性程度之间的相关性,以及胰腺 PDFF 与脂肪变性程度和肝 PDFF 之间的相关性。为了比较慢性病毒性肝炎组和 NALD 组,我们对连续或有序变量使用 t 检验,对分类变量使用卡方检验。

结果

肝 PDFF 测量值与脂肪变性程度呈高度相关(R=0.875,p<0.001)。胰腺 PDFF 与肝脂肪变性程度(R=0.573,p<0.001)和肝 PDFF 测量值(R=0.536,p<0.001)呈正相关。在慢性 NALD 患者亚组中,胰腺 PDFF 与肝 PDFF(R=0.632,p<0.001)和胰腺 PDFF 与肝脏脂肪变性(R=0.608,p<0.001)之间的相关性仍然显著;然而,在病毒性肝炎患者亚组中,这些相关性不再显著。

结论

慢性 NALD 患者胰腺脂肪沉积与肝脂肪变性相关,但在慢性病毒性肝炎患者中不相关。

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