Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou 510120, Guangdong Province, China.
World J Gastroenterol. 2020 Sep 7;26(33):4996-5007. doi: 10.3748/wjg.v26.i33.4996.
Liver fat accumulation is associated with increased cholesterol synthesis and hypersecretion of biliary cholesterol, which may be related to the development of cholelithiasis.
To investigate whether liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy (MRS) is a risk factor for cholelithiasis.
Forty patients with cholelithiasis and thirty-one healthy controls were retrospectively enrolled. The participants underwent high-speed T2-corrected multi-echo single-voxel MRS of the liver at a 3T MR scanner. The proton density fat fraction (PDFF) and R2 value were calculated. Serum parameters and waist circumference (WC) were recorded. Spearman's correlation analysis was used to analyze the relationship between PDFF, R2, and WC values. Multivariate logistic regression analysis was carried out to determine the significant predictors of the risk of cholelithiasis. Receiver operating characteristic curve (ROC) analysis was used to evaluate the discriminative performance of significant predictors.
Patients with cholelithiasis had higher PDFF, R2, and WC values compared with healthy controls (5.8% ± 4.2% 3.3% ± 2.4%, = 0.001; 50.4 ± 24.8/s 38.3 ± 8.8/s, = 0.034; 85.3 ± 9.0 cm 81.0 ± 6.9 cm, = 0.030; respectively). Liver iron concentration extrapolated from R2 values was significantly higher in the cholelithiasis group (2.21 ± 2.17 mg/g dry tissue 1.22 ± 0.49 mg/g dry tissue, = 0.034) than in the healthy group. PDFF was positively correlated with WC ( = 0.502, < 0.001) and R2 ( = 0.425, < 0.001). Multivariate logistic regression analysis showed that only PDFF was an independent risk factor for cholelithiasis (odds ratio = 1.79, 95%CI: 1.22-2.62, = 0.003). ROC analysis showed that the area under the curve of PDFF was 0.723 for discriminating cholelithiasis from healthy controls, with a sensitivity of 55.0% and specificity of 83.9% when the cut-off value of PDFF was 4.4%.
PDFF derived from high speed T2-corrected multi-echo MRS can predict the risk of cholelithiasis.
肝脂肪堆积与胆固醇合成增加和胆汁胆固醇分泌过度有关，这可能与胆石症的发展有关。
探讨高速 T2 校正多回波磁共振波谱（MRS）测量的肝脂肪堆积是否是胆石症的危险因素。
回顾性纳入 40 例胆石症患者和 31 例健康对照者。参与者在 3.0TMR 扫描仪上进行高速 T2 校正多回波单体素 MRS 肝脏检查。计算质子密度脂肪分数（PDFF）和 R2 值。记录血清参数和腰围（WC）。采用 Spearman 相关分析分析 PDFF、R2 和 WC 值之间的关系。采用多元 logistic 回归分析确定胆石症风险的显著预测因素。采用受试者工作特征曲线（ROC）分析评估显著预测因素的判别性能。
胆石症患者的 PDFF、R2 和 WC 值高于健康对照组（5.8%±4.2%比 3.3%±2.4%， = 0.001；50.4±24.8/s 比 38.3±8.8/s， = 0.034；85.3±9.0cm 比 81.0±6.9cm， = 0.030；分别）。胆石症组肝脏铁浓度从 R2 值外推明显高于健康组（2.21±2.17mg/g 干组织比 1.22±0.49mg/g 干组织， = 0.034）。PDFF 与 WC 呈正相关（ = 0.502， ＜0.001）和 R2（ = 0.425， ＜0.001）。多元 logistic 回归分析显示，只有 PDFF 是胆石症的独立危险因素（比值比=1.79，95%CI：1.22-2.62， = 0.003）。ROC 分析显示，PDFF 区分胆石症与健康对照组的曲线下面积为 0.723，当 PDFF 截断值为 4.4%时，其敏感性为 55.0%，特异性为 83.9%。
高速 T2 校正多回波 MRS 衍生的 PDFF 可预测胆石症的风险。
