Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Abdom Radiol (NY). 2022 Nov;47(11):3733-3745. doi: 10.1007/s00261-022-03618-x. Epub 2022 Aug 13.
We aimed to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and transient elastography (TE) in assessing liver fibrosis and steatosis in patients with chronic liver disease (CLD).
Patients who underwent liver biopsy or liver surgery at two academic hospitals between 2017 and 2021 were retrospectively recruited. The stages of liver fibrosis and steatosis were evaluated using histologic examination. Liver stiffness (LS) was assessed using MR elastography (LS) and TE (LS). Liver steatosis was assessed using proton density fat fraction (PDFF) and controlled attenuation parameter (CAP).
The mean age of the study population (n = 280) was 53.6 years and male sex predominated (n = 199, 71.1%). Nonalcoholic fatty liver disease was the most prevalent (n = 127, 45.5%), followed by hepatitis B virus (n = 112, 40.0%). Hepatocellular carcinoma was identified in 130 patients (46.4%). The proportions of F0, F1, F2, F3, and F4 fibrosis were 13.2%, 31.1%, 9.6%, 16.4%, and 29.7%, respectively. LS had a significantly greater AUROC value than LS for detecting F2-F4 (0.846 vs. 0.781, P = 0.046), whereas LS and LS similarly predicted F1-4, F3-4, and F4 (all P > 0.05). The proportions of S0, S1, S2, and S3 steatosis were 34.7%, 49.6%, 12.5%, and 3.2%, respectively. PDFF had significantly greater AUROC values than CAP in predicting S1-3 (0.922 vs. 0.806, P < 0.001) and S2-3 (0.924 vs. 0.795, P = 0.005); however, PDFF and CAP similarly predicted S3 (P = 0.086).
MRI exhibited significantly higher diagnostic accuracy than TE for detecting significant fibrosis and mild or moderate steatosis in patients with CLD.
我们旨在比较磁共振成像（MRI）和瞬时弹性成像（TE）在评估慢性肝病（CLD）患者肝纤维化和脂肪变性中的诊断准确性。
回顾性招募了 2017 年至 2021 年在两所学术医院接受肝活检或肝手术的患者。使用组织学检查评估肝纤维化和脂肪变性的分期。使用磁共振弹性成像（LS）和 TE（LS）评估肝硬度（LS）。使用质子密度脂肪分数（PDFF）和受控衰减参数（CAP）评估肝脂肪变性。
研究人群（n=280）的平均年龄为 53.6 岁，男性为主（n=199，71.1%）。非酒精性脂肪性肝病最为常见（n=127，45.5%），其次是乙型肝炎病毒（n=112，40.0%）。130 例患者发现肝细胞癌（46.4%）。纤维化分期为 F0、F1、F2、F3 和 F4 的比例分别为 13.2%、31.1%、9.6%、16.4%和 29.7%。LS 检测 F2-F4 的 AUROC 值显著大于 LS（0.846 对 0.781，P=0.046），而 LS 和 LS 同样预测 F1-4、F3-4 和 F4（均 P>0.05）。脂肪变性分期为 S0、S1、S2 和 S3 的比例分别为 34.7%、49.6%、12.5%和 3.2%。PDFF 在预测 S1-3（0.922 对 0.806，P<0.001）和 S2-3（0.924 对 0.795，P=0.005）时的 AUROC 值显著大于 CAP；然而，PDFF 和 CAP 同样预测 S3（P=0.086）。
MRI 检测 CLD 患者明显纤维化和轻度或中度脂肪变性的诊断准确性明显高于 TE。
