定量磁敏感图与 R2* 直方图分析评估肝纤维化：初步结果。
Quantitative Susceptibility Mapping versus R2*-based Histogram Analysis for Evaluating Liver Fibrosis: Preliminary Results.
机构信息
Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine.
Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine.
出版信息
Magn Reson Med Sci. 2022 Oct 1;21(4):609-622. doi: 10.2463/mrms.mp.2020-0175. Epub 2021 Nov 11.
PURPOSE
The staging of liver fibrosis is clinically important, and a less invasive method is preferred. Quantitative susceptibility mapping (QSM) has shown a great potential in estimating liver fibrosis in addition to R2* relaxometry. However, few studies have compared QSM analysis and liver fibrosis. We aimed to evaluate the feasibility of estimating liver fibrosis by using QSM and R2*-based histogram analyses by comparing it with ultrasound-based transient elastography and the stage of histologic fibrosis.
METHODS
Fourteen patients with liver disease were enrolled. Data sets of multi-echo gradient echo sequence with breath-holding were acquired on a 3-Tesla scanner. QSM and R2* were reconstructed by water-fat separation method, and ROIs were analyzed for these images. Quantitative parameters with histogram features (mean, variance, skewness, kurtosis, and 1st, 10th, 50th, 90th, and 99th percentiles) were extracted. These data were compared with the elasticity measured by ultrasound transient elastography and histological stage of liver fibrosis (F0 to F4, based on the new Inuyama classification) determined by biopsy or hepatectomy. The correlation of histogram parameters with intrahepatic elasticity and histologically confirmed fibrosis stage was examined. Texture parameters were compared between subgroups divided according to fibrosis stage. Receiver operating characteristic (ROC) analysis was also performed. P < 0.05 indicated statistical significance.
RESULTS
The six histogram parameters of both QSM and R2were significantly correlated with intrahepatic elasticity. In particular, three parameters (variance, percentiles [90th and 99th]) of QSM showed high correlation (r = 0.818-0.844), whereas R2 parameters showed a moderate correlation with elasticity. Four parameters of QSM were significantly correlated with fibrosis stage (ρ = 0.637-0.723) and differentiated F2-4 from F0-1 fibrosis and F3-4 from F0-2 fibrosis with areas under the ROC curve of > 0.8, but those of R2* did not.
CONCLUSION
QSM may serve as a promising surrogate indicator in detecting liver fibrosis.
目的
肝纤维化分期具有重要的临床意义，因此人们更倾向于使用一种非侵入性方法。定量磁化率映射（QSM）除了 R2弛豫率外，在评估肝纤维化方面也显示出巨大的潜力。然而，很少有研究比较过 QSM 分析与肝纤维化。我们旨在通过与基于超声的瞬时弹性成像和组织学纤维化分期比较，评估 QSM 及其基于 R2的直方图分析来评估肝纤维化的可行性。
方法
本研究纳入了 14 名肝病患者。在 3T 扫描仪上采集了屏息多回波梯度回波序列的数据。采用水脂分离法重建 QSM 和 R2*图像，并对这些图像进行 ROI 分析。提取了这些图像的定量参数及其直方图特征（平均值、方差、偏度、峰度以及第 1、10、50、90 和 99 百分位数）。这些数据与超声瞬时弹性成像测量的弹性值和通过活检或肝切除术确定的组织学肝纤维化分期（基于新的 Inuyama 分类，F0 至 F4）进行比较。检验了直方图参数与肝内弹性和组织学证实的纤维化分期的相关性。根据纤维化分期将患者分为不同亚组，并对纹理参数进行了比较。还进行了受试者工作特征（ROC）分析。P<0.05 表示具有统计学意义。
结果
QSM 和 R2的六个直方图参数均与肝内弹性显著相关。特别是 QSM 的三个参数（方差、百分位数[第 90 和 99 百分位数]）相关性较高（r=0.818-0.844），而 R2参数与弹性呈中度相关。QSM 的四个参数与纤维化分期显著相关（ρ=0.637-0.723），可以区分 F2-4 期与 F0-1 期纤维化，以及 F3-4 期与 F0-2 期纤维化，ROC 曲线下面积>0.8，而 R2*的参数则没有。
结论
QSM 可能是一种有前途的肝纤维化检测替代指标。
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