声辐射力脉冲弹性成像与磁共振弥散加权成像对慢性肝炎纤维化程度的比较。
Comparison of the fibrosis degree using acoustic radiation force impulse elastography and diffusion-weighted magnetic resonance imaging in chronic hepatitis cases.
机构信息
Hatay Education and Research Hospital, Department of Radiology - Antakya, Turkey.
Health Sciences University, Gulhane Education and Research Hospital, Department of Radiology - Ankara, Turkey.
出版信息
Rev Assoc Med Bras (1992). 2023 Oct 6;69(8):e20221723. doi: 10.1590/1806-9282.20221723. eCollection 2023.
OBJECTIVE
The aim of this study was to investigate the correlation of fibrosis stages in cases of chronic hepatitis by comparing shear wave elastography and diffusion-weighted magnetic resonance imaging.
METHODS
A total of 46 chronic hepatitis patients with an age range of 20-50 years were classified into three groups based on their fibrosis stages. Comparison group 1: the presence of fibrosis (S0 and S1≤); comparison group 2: the presence of significant fibrosis (≤S2 and S3≤); and comparison group 3: the presence of cirrhosis (≤S4 and S6). Shear wave velocities were measured by acoustic radiation force impulse elastography. Diffusion-weighted magnetic resonance imaging was performed on a 3.0 Tesla MRI device.
RESULTS
In comparison group 1 (S0 and S1≤), the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.784, 87, and 60%, respectively, while these values were 0.718, 80, and 66%, respectively, for apparent diffusion coefficient . In comparison group 2 (≤S2 and S3≤), the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.917, 80, and 86%, respectively, and the apparent diffusion coefficient values were 0.778, 90, and 66%, respectively. In comparison group 3, the area under the curve, sensitivity, and specificity of acoustic radiation force impulse values were 0.977, 100, and 95%, respectively. There was no statistically significant difference between the apparent diffusion coefficient values of the cases in the three groups (p=0.132).
CONCLUSION
Noninvasive methods are gaining importance day by day for staging hepatic fibrosis. Acoustic radiation force impulse elastography was evaluated as a more reliable examination than diffusion-weighted magnetic resonance imaging in revealing the presence of fibrosis, determining significant fibrosis, and diagnosing cirrhosis.
目的
本研究旨在通过比较剪切波弹性成像和磁共振弥散加权成像，探讨慢性肝炎纤维化分期的相关性。
方法
将年龄在 20-50 岁之间的 46 例慢性肝炎患者根据纤维化分期分为三组。比较组 1：存在纤维化（S0 和 S1≤）；比较组 2：存在显著纤维化（S2 和 S3≤）；比较组 3：存在肝硬化（S4 和 S6≤）。应用声辐射力脉冲弹性成像测量剪切波速度，在 3.0T MRI 设备上进行磁共振弥散加权成像。
结果
在比较组 1（S0 和 S1≤）中，声辐射力脉冲弹性成像值的曲线下面积、敏感度和特异度分别为 0.784、87%和 60%，而表观弥散系数分别为 0.718、80%和 66%。在比较组 2（S2 和 S3≤）中，声辐射力脉冲弹性成像值的曲线下面积、敏感度和特异度分别为 0.917、80%和 86%，表观弥散系数值分别为 0.778、90%和 66%。在比较组 3 中，声辐射力脉冲弹性成像值的曲线下面积、敏感度和特异度分别为 0.977、100%和 95%。三组病例的表观弥散系数值无统计学差异（p=0.132）。
结论
非侵入性方法在肝纤维化分期中的重要性日益增加。声辐射力脉冲弹性成像在显示纤维化、确定显著纤维化和诊断肝硬化方面被评估为比磁共振弥散加权成像更可靠的检查方法。
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