Department of Radiology, University of Palermo, Palermo, Italy.
Radiology Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
Neuroradiology. 2022 Oct;64(10):1969-1978. doi: 10.1007/s00234-022-02949-2. Epub 2022 Apr 30.
Hepatic encephalopathy (HE) is a potential complication of cirrhosis. Magnetic resonance imaging (MRI) may demonstrate hyperintense T1 signal in the globi pallidi. The purpose of this study was to evaluate the performance of MRI-based radiomic features for diagnosing and grading chronic HE in adult patients affected by cirrhosis.
Adult patients with and without cirrhosis underwent brain MRI with identical imaging protocol on a 3T scanner. Patients without history of chronic liver disease were the control population. HE grading was based on underlying liver disease, severity of clinical manifestation, and number of encephalopathic episodes. Texture analysis was performed on axial T1-weighted images on bilateral lentiform nuclei at the level of the foramina of Monro. Diagnostic performance of texture analysis for the diagnosis and grading of HE was assessed by calculating the area under the receiver operating characteristics (AUROC) with 95% confidence interval (CI).
The final study population consisted of 124 patients, 70 cirrhotic patients, and 54 non-cirrhotic controls. Thirty-eight patients had history of HE with 22 having an HE grade > 1. The radiomic features predicted the presence of HE with an AUROC of 0.82 (95% CI: 0.73, 0.90; P < .0001; 82% sensitivity, 66% specificity). Radiomic features predicted grade 1 HE (AUROC 0.75; 95% CI: 0.61, 0.89; P < .0001; 94% sensitivity, 60% specificity) and grade ≥ 2 HE (AUROC 0.82; 95% CI: 0.71, 0.93; P < .0001, 95% sensitivity, 57% specificity).
In cirrhotic patients, MR radiomic is effective in predicting the presence of chronic HE and in grading its severity.
肝性脑病（HE）是肝硬化的潜在并发症。磁共振成像（MRI）可能显示苍白球的 T1 信号高信号。本研究旨在评估基于 MRI 的放射组学特征在诊断和分级成人肝硬化患者慢性 HE 中的性能。
在 3T 扫描仪上进行了具有相同成像方案的脑 MRI 检查，包括患有和不患有肝硬化的成年患者。没有慢性肝病病史的患者为对照组。HE 分级基于潜在的肝病、临床表现的严重程度和脑病发作的次数。在中脑孔水平的双侧豆状核上对轴向 T1 加权图像进行纹理分析。通过计算接收者操作特征（ROC）曲线下的面积（AUROC）及其 95%置信区间（CI）来评估纹理分析对 HE 的诊断和分级的诊断性能。
最终研究人群包括 124 例患者，70 例肝硬化患者和 54 例非肝硬化对照组。38 例患者有 HE 病史，其中 22 例 HE 分级>1。放射组学特征预测 HE 的存在具有 0.82 的 AUROC（95%CI：0.73，0.90；P<0.0001；82%敏感性，66%特异性）。放射组学特征预测 1 级 HE（AUROC 0.75；95%CI：0.61，0.89；P<0.0001；94%敏感性，60%特异性）和≥2 级 HE（AUROC 0.82；95%CI：0.71，0.93；P<0.0001，95%敏感性，57%特异性）。
在肝硬化患者中，MR 放射组学有效预测慢性 HE 的存在及其严重程度。
