用于评估非酒精性脂肪性肝病肝纤维化的天然及钆塞酸二钠增强T1映射：改良Look-Locker反转恢复序列与水特异性T1映射的对比分析
Native and Gd-EOB-DTPA-Enhanced T1 mapping for Assessment of Liver Fibrosis in NAFLD: Comparative Analysis of Modified Look-Locker Inversion Recovery and Water-specific T1 mapping.
作者信息
Yang Ru, Peng Hao, Pan Jing, Wan Qian, Zou Chao, Hu Fubi
机构信息
Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, No.278, Baoguang Road, Xindu District, Chengdu, Sichuan, China (R.Y., J.P., F.H.).
Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, China (H.P., Q.W., C.Z.).
出版信息
Acad Radiol. 2025 Jan;32(1):170-179. doi: 10.1016/j.acra.2024.07.009. Epub 2024 Jul 23.
RATIONALE AND OBJECTIVES
To investigate the diagnostic performance of water-specific T1 mapping for staging liver fibrosis in a non-alcoholic fatty liver disease (NAFLD) rabbit model, in comparison to Modified Look-Locker Inversion recovery (MOLLI) T1 mapping.
MATERIALS AND METHODS
60 rabbits were randomly divided into the control group (12 rabbits) and NAFLD model groups (eight rabbits per subgroup) corresponding to different durations of high-fat high cholesterol diet feeding. All rabbits underwent MRI examination including MOLLI T1 mapping and 3D multi-echo variable flip angle (VFAME- GRE) sequences were acquired before and 20 min after the administration of Gd- EOB-DTPA. Histological assessments were performed to evaluate steatosis, inflammation, ballooning, and fibrosis. Statistical analysis included the intraclass correlation coefficient, analysis of variance, spearman correlation, multiple linear regression, and receiver operating characteristic curve.
RESULTS
A moderate correlation was observed between conventional native T1 and MRI-PDFF (r = -0.513, P < 0.001), as well as between conventional native T1 and liver steatosis grades (r = -0.319, P = 0.016). However, no significant correlation was found between the native wT1 and PDFF (r = 0.137, P = 0.314), or between the native wT1 and steatosis grades (r = 0.106, P = 0.435). In the multiple regression analysis, liver fibrosis, and hepatocellular ballooning were identified as independent factors influencing native wT1 in this study (R2 =0.545, P < 0.05), while steatosis was independently associated with conventional native T1 (R2 =0.321, P < 0.05). The AUC values for native T1, native wT1, HBP T1, and HBP wT1 were 0.549(0.410-0.682), 0.811(0.684-0.903), 0.775(0.644-0.876), and 0.752(0.619-0.858) for F1 or higher, 0.581(0.441-0.711), 0.828(0.704-0.916), 0.832(0.708-0.919), and 0.854(0.734-0.934) for F2 or higher, respectively.
CONCLUSION
The native wT1 may provide a more reliable assessment of early liver fibrosis in the context of NAFLD compared to conventional native T1.
原理与目的
与改良Look-Locker反转恢复序列（MOLLI）T1映射相比，研究水特异性T1映射在非酒精性脂肪性肝病（NAFLD）兔模型中对肝纤维化分期的诊断性能。
材料与方法
60只兔子随机分为对照组（12只兔子）和NAFLD模型组（每个亚组8只兔子），对应不同时长的高脂高胆固醇饮食喂养。所有兔子均接受MRI检查，包括MOLLI T1映射，并在注射钆塞酸二钠（Gd-EOB-DTPA）前和注射后20分钟采集三维多回波可变翻转角（VFAME-GRE）序列。进行组织学评估以评价脂肪变性、炎症、气球样变和纤维化。统计分析包括组内相关系数、方差分析、Spearman相关性分析、多元线性回归分析以及受试者操作特征曲线分析。
结果
常规T1值与MRI-PDFF之间存在中度相关性（r = -0.513，P < 0.001），常规T1值与肝脏脂肪变性分级之间也存在中度相关性（r = -0.319，P = 0.016）。然而，水特异性T1值（wT1）与PDFF之间未发现显著相关性（r = 0.137，P = 0.314），wT1与脂肪变性分级之间也未发现显著相关性（r = 0.106，P = 0.435）。在多元回归分析中，本研究确定肝纤维化和肝细胞气球样变为影响水特异性T1值（wT1）的独立因素（R2 = 0.545，P < 0.05），而脂肪变性与常规T1值独立相关（R2 = 0.321，P < 0.05）。F1及以上纤维化时，常规T1值、水特异性T1值、肝胆期T1值（HBP T1）和肝胆期水特异性T1值（HBP wT1）的AUC值分别为0.549（0.410 - 0.682）、0.811（0.684 - 0.903）、0.775（0.644 - 0.876）和0.752（0.619 - 0.858）；F2及以上纤维化时，其AUC值分别为0.581（0.441 - 0.711）、0.828（0.704 - 0.916）、0.832（0.708 - 0.919）和0.854（0.734 - 0.934）。
结论
与常规T1值相比，在NAFLD背景下，水特异性T1值（wT1）可能为早期肝纤维化提供更可靠的评估。
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