Department of Radiology, Interventional Radiology, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, United States of America.
PLoS One. 2024 Aug 22;19(8):e0308520. doi: 10.1371/journal.pone.0308520. eCollection 2024.
To evaluate for correlation between MRI paraspinous muscle (PSM) enhancement and clinical measures of cirrhosis severity (CMCS) utilizing established imaging biomarkers of sarcopenia as comparison.
Retrospective evaluation of 224 patients (mean age 59.6± 9.7 years, 135 males and 89 females) with liver cirrhosis who underwent contrast-enhanced MRI between August 2021 and August 2022 was performed. Assessed variables included: body mass index (BMI), varices and ascites present on imaging (VPI and API), albumin, total bilirubin (Tbili), international normalized ratio (INR), creatinine, MELD score, as well as history of paracentesis (PH), spontaneous bacterial peritonitis, and variceal bleed (VBH). These variables were compared to PSM skeletal muscle index (SMI), PSM signal fat fractions (sFF), and PSM contrast enhancement fraction (CEFR) calculated on arterial (CEFR-ART), portal venous (CEFR-PV), and delayed (CEFR-DEL) phases collected on MRI.
Patients with MELD>17, PH, and VPI had lower PSM CEFR-ART (0.06vs. 0.11, p = 0.01; 0.07vs. 0.11, p = 0.01; and 0.09vs. 0.13, p = 0.03, respectively). PSM CEFR-ART correlated negatively with MELD. Patients with MELD>17 and PH had lower PSM CEFR-PV (0.16vs. 0.23, p = 0.02; 0.18 vs. 0.23, p = 0.01, respectively). PSM CEFR-PV correlated positively with albumin and negatively with Tbili, INR, and MELD. PSM CEFR-DEL correlated negatively with Tbili and MELD. Patients with API, PH, and VBH had lower PSM SMI (4.68vs. 5.59, p<0.001; 4.37vs. 5.48, p<0.001; 4.78vs. 5.35, p = 0.04, respectively). PSM SMI correlated negatively with Tbili and positively with BMI. PSM sFF correlated positively with BMI, PSM CEFR-PV, and PSM CEFR-DEL.
PSM CEFR is significantly reduced on MRI in patients with clinical manifestations of severe liver cirrhosis. Further investigation into PSM CEFR's usefulness as an imaging biomarker for evaluating liver disease severity is warranted.
利用已建立的肌少症影像学标志物，评估 MRI 脊柱旁肌肉（PSM）增强与肝硬化严重程度的临床指标（CMCS）之间的相关性。
回顾性分析了 2021 年 8 月至 2022 年 8 月期间 224 例患有肝硬化的患者（平均年龄 59.6±9.7 岁，135 名男性和 89 名女性）的对比增强 MRI 检查结果。评估的变量包括：体重指数（BMI）、影像学上存在的静脉曲张和腹水（VPI 和 API）、白蛋白、总胆红素（Tbili）、国际标准化比值（INR）、肌酐、MELD 评分以及是否进行过腹腔穿刺术（PH）、自发性细菌性腹膜炎和静脉曲张出血（VBH）。将这些变量与 PSM 骨骼肌指数（SMI）、PSM 信号脂肪分数（sFF）和 PSM 对比增强分数（CEFR）进行比较，后者是在 MRI 上采集的动脉期（CEFR-ART）、门静脉期（CEFR-PV）和延迟期（CEFR-DEL）上计算得出的。
MELD>17、PH 和 VPI 的患者 PSM CEFR-ART 较低（0.06 比 0.11，p=0.01；0.07 比 0.11，p=0.01；0.09 比 0.13，p=0.03）。PSM CEFR-ART 与 MELD 呈负相关。MELD>17 和 PH 的患者 PSM CEFR-PV 较低（0.16 比 0.23，p=0.02；0.18 比 0.23，p=0.01）。PSM CEFR-PV 与白蛋白呈正相关，与 Tbili、INR 和 MELD 呈负相关。PSM CEFR-DEL 与 Tbili 和 MELD 呈负相关。API、PH 和 VBH 的患者 PSM SMI 较低（4.68 比 5.59，p<0.001；4.37 比 5.48，p<0.001；4.78 比 5.35，p=0.04）。PSM SMI 与 Tbili 呈负相关，与 BMI 呈正相关。PSM sFF 与 BMI、PSM CEFR-PV 和 PSM CEFR-DEL 呈正相关。
在有严重肝硬化临床表现的患者中，MRI 上 PSM CEFR 显著降低。需要进一步研究 PSM CEFR 作为评估肝脏疾病严重程度的影像学生物标志物的有用性。
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