肝和脾 T 映射的 native 和 gadoxetate 增强性能在非侵入性诊断临床显著门脉高压中的应用：初步结果。
Performance of native and gadoxetate-enhanced liver and spleen T mapping for noninvasive diagnosis of clinically significant portal hypertension: preliminary results.
机构信息
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.
BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
Abdom Radiol (NY). 2022 Nov;47(11):3758-3769. doi: 10.1007/s00261-022-03645-8. Epub 2022 Sep 9.
PURPOSE
In this preliminary study, our aim was to assess the utility of quantitative native-T (T-pre), iron-corrected T (cT) of the liver/spleen and T mapping of the liver obtained during hepatobiliary phase (T-HBP) post-gadoxetate disodium, compared to spleen size/volume and APRI (aspartate aminotransferase-to-platelet ratio index) for noninvasive diagnosis of clinically significant portal hypertension [CSPH, defined as hepatic venous pressure gradient (HVPG) ≥ 10 mm Hg].
METHODS
Forty-nine patients (M/F: 27/22, mean age 53y) with chronic liver disease, HVPG measurement and MRI were included. Breath-held T and cT measurements were obtained using an inversion recovery Look-Locker sequence and a T2* corrected modified Look-Locker sequence, respectively. Liver T-pre (n = 49), spleen T (obtained pre-contrast, n = 47), liver and spleen cT (both obtained pre-contrast, n = 30), liver T-HBP (obtained 20 min post gadoxetate disodium injection, n = 36) and liver T uptake (ΔT, n = 36) were measured. Spleen size/volume and APRI were also obtained. Spearman correlation coefficients were used to assess the correlation between each of liver/spleen T/cT parameters, spleen size/volume and APRI with HVPG. ROC analysis was performed to determine the performance of measured parameters for diagnosis of CSPH.
RESULTS
There were 12/49 (24%) patients with CSPH. Liver T-pre (r = 0.287, p = 0.045), liver T-HBP (r = 0.543, p = 0.001), liver ΔT (r = - 0.437, p = 0.008), spleen T (r = 0.311, p = 0.033) and APRI (r = 0.394, p = 0.005) were all significantly correlated with HVPG, while liver cT, spleen cT and spleen size/volume were not. The highest AUCs for the diagnosis of CSPH were achieved with liver T-HBP, liver ΔT and spleen T: 0.881 (95%CI 0.76-1.0, p = 0.001), 0.852 (0.72-0.98, p = 0.002) and 0.781 (0.60-0.95, p = 0.004), respectively.
CONCLUSION
Our preliminary results demonstrate the potential of liver T mapping obtained during HBP post gadoxetate disodium for the diagnosis of CSPH. These results require further validation.
目的
在这项初步研究中，我们旨在评估定量天然 T（T-pre）、铁校正 T（cT）的肝/脾和肝 T 映射（T-HBP）在获得后肝胆期（post-gadoxetate disodium），与脾大小/体积和 APRI（天冬氨酸氨基转移酶与血小板比值指数）在诊断临床显著门脉高压（CSPH，定义为肝静脉压力梯度[HVPG]≥10mmHg）方面的应用。
方法
纳入 49 例慢性肝病患者（男/女：27/22，平均年龄 53 岁），进行 HVPG 测量和 MRI 检查。采用反转恢复 Look-Locker 序列和 T2*校正的改良 Look-Locker 序列获得呼吸暂停 T 和 cT 测量值。测量了 49 例患者的肝脏 T-pre（n=49）、脾脏 T（未增强时，n=47）、肝脏和脾脏 cT（均未增强时，n=30）、肝脏 T-HBP（增强后 20 分钟，n=36）和肝脏 T 摄取（ΔT，n=36）。还获得了脾脏大小/体积和 APRI。采用 Spearman 相关系数评估肝脏/脾脏 T/cT 参数、脾脏大小/体积和 APRI 与 HVPG 之间的相关性。采用 ROC 分析确定测量参数在诊断 CSPH 中的性能。
结果
有 12/49（24%）例患者存在 CSPH。肝脏 T-pre（r=0.287，p=0.045）、肝脏 T-HBP（r=0.543，p=0.001）、肝脏ΔT（r=−0.437，p=0.008）、脾脏 T（r=0.311，p=0.033）和 APRI（r=0.394，p=0.005）均与 HVPG 显著相关，而肝脏 cT、脾脏 cT 和脾脏大小/体积则无相关性。肝脏 T-HBP、肝脏ΔT 和脾脏 T 用于诊断 CSPH 的 AUC 值最高：0.881（95%CI 0.76-1.0，p=0.001）、0.852（0.72-0.98，p=0.002）和 0.781（0.60-0.95，p=0.004）。
结论
我们的初步结果表明，在获得肝胆期后，使用钆塞酸二钠获得的肝 T 映射在诊断 CSPH 方面具有潜力。这些结果需要进一步验证。
Zotero 插件