Sim Byeong Hak, Heo Suk Hee, Shin Sang Soo, Cho Seong Beom, Jeong Yong Yeon
Taehan Yongsang Uihakhoe Chi. 2020 Mar;81(2):365-378. doi: 10.3348/jksr.2020.81.2.365. Epub 2020 Feb 18.
This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease.
One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis.
PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis.
PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.
本研究旨在确定钆塞酸增强肝脏磁共振成像的T1弛豫时间是否有助于检测慢性肝病患者的肝纤维化并进行分期。
103例疑似肝脏局灶性病变患者接受了磁共振成像和Fibroscan检查。选择Fibroscan作为肝纤维化分类的参考标准。使用3T磁共振成像,在横轴位3D VIBE(容积内插屏气检查)序列上获取对比剂注射前(preT1)、注射后20分钟(postT1)的T1弛豫时间以及T1弛豫时间缩短率(rrT1)。通过ROC分析确定肝纤维化分期的最佳截断值。
根据METAVIR评分(F0 - F4),随着肝纤维化严重程度的增加,preT1和postT1升高,rrT1降低。F2和F3之间的preT1有统计学显著差异(F2,836.0 ± 74.7毫秒;F3,888.6 ± 77.5毫秒,P < 0.05),F3和F4之间的postT1(F3,309.0 ± 80.2毫秒;F4,406.6 ± 147.7毫秒,P < 0.05)和rrT1(F3,65.4 ± 7.7%;F4,57.3 ± 11.4%,P < 0.05)有统计学显著差异。ROC分析显示联合检测(preT1 + postT1)是预测肝纤维化的最佳检测方法。
随着肝纤维化严重程度的增加,preT1和postT1持续升高。钆塞酸增强肝脏磁共振成像中的T1 mapping可作为确定肝纤维化分期的有用补充序列。