University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany.
University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany.
Magn Reson Imaging. 2021 Apr;77:7-13. doi: 10.1016/j.mri.2020.12.005. Epub 2020 Dec 9.
Chronic liver diseases pose a major health problem worldwide, while common tests for diagnosis and monitoring of diffuse hepatopathy have considerable limitations. Preliminary data on the quantification of hepatic extracellular volume fraction (ECV) with magnetic resonance imaging (MRI) for non-invasive assessment of liver fibrosis are encouraging, with ECV having the potential to overcome several of these constraints.
To clinically evaluate ECV provided by quantitative MRI for assessing the severity of liver disease.
In this prospective study, multiparametric liver MRI, including T1 mapping and magnetic resonance elastography (MRE), was performed in subjects with and without hepatopathy between November 2018 and October 2019. T1, T2, T2*, proton density fat fraction and stiffness were extracted from parametric maps by regions of interest and ECV was calculated from T1 relaxometries. Serum markers of liver disease were obtained by clinical database research. For correlation analysis, Spearman rank correlation was used. ROC analysis of serum markers and quantitative MRI data for discrimination of liver cirrhosis was performed with MRE as reference standard.
109 participants were enrolled (50.7 ± 16.1 years, 61 men). ECV, T1 and MRE correlated significantly with almost all serum markers of liver disease, with ECV showing the strongest associations (up to r = 0.67 with MELD, p < 0.01). ECV and T1 correlated with MRE (0.75 and 0.73, p < 0.01 each). ECV (AUC 0.89, cutoff 32.2%, sensitivity 85%, specificity 87%) and T1 mapping (AUC 0.85, cutoff 592.5 ms, sensitivity 83%, specificity 75%) featured good performances in detection of liver cirrhosis with only ECV performing significantly superior to model of end stage liver disease (MELD), AST/ALT ratio and international normalized ratio (p < 0.01, respectively).
Quantification of hepatic extracellular volume fraction with MRI is suitable for estimating the severity of liver disease when using MRE as the standard of reference. It represents a promising tool for non-invasive assessment of liver fibrosis and cirrhosis.
慢性肝脏疾病是全球范围内的一个主要健康问题，而用于诊断和监测弥漫性肝病的常用检测方法存在相当大的局限性。初步数据表明，磁共振成像（MRI）测量肝细胞外容积分数（ECV）可用于非侵入性评估肝纤维化，ECV 具有克服这些限制的潜力。
临床评估定量 MRI 提供的 ECV 用于评估肝病严重程度。
在这项前瞻性研究中，2018 年 11 月至 2019 年 10 月，对患有和不患有肝病的受试者进行了多参数肝脏 MRI 检查，包括 T1 映射和磁共振弹性成像（MRE）。通过感兴趣区从参数图中提取 T1、T2、T2*、质子密度脂肪分数和硬度值，并通过 T1 弛豫率计算 ECV。通过临床数据库研究获得肝脏疾病的血清标志物。相关性分析采用 Spearman 秩相关。以 MRE 为参考标准，对血清标志物和定量 MRI 数据进行 ROC 分析，以区分肝硬化。
共纳入 109 名受试者（50.7±16.1 岁，61 名男性）。ECV、T1 和 MRE 与几乎所有肝脏疾病的血清标志物均显著相关，其中 ECV 相关性最强（与 MELD 的相关性最高，r=0.67，p<0.01）。ECV 与 T1 与 MRE 相关（0.75 和 0.73，p<0.01）。ECV（AUC 0.89，截断值 32.2%，灵敏度 85%，特异性 87%）和 T1 映射（AUC 0.85，截断值 592.5ms，灵敏度 83%，特异性 75%）在检测肝硬化方面表现良好，仅 ECV 明显优于终末期肝病模型（MELD）、AST/ALT 比值和国际标准化比值（p<0.01）。
使用 MRE 作为参考标准，MRI 测量肝细胞外容积分数可用于评估肝病的严重程度。它是一种有前途的用于评估肝纤维化和肝硬化的非侵入性工具。
