Sun Ziqing, Duan Mengjiao, Huang Mengyue, Yao Feifei, Zhang Xiaopan, Zhang Yong, Wang Kaiyu, Liu Jingjing
Department of MR Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
MR Research China, GE Healthcare, Beijing, China.
Abdom Radiol (NY). 2025 Sep 13. doi: 10.1007/s00261-025-05197-z.
This study aims to detect decompensation in cirrhotic patients with varying volumes of ascites using magnetic resonance elastography (MRE).
We prospectively reviewed 70 patients with liver cirrhosis who underwent 3D MRE and gadoxetic acid-enhanced magnetic resonance imaging (MRI). Patients were categorized into three groups based on clinical information and ascitic volume: compensated cirrhosis with no or minimal ascites (Group A, n = 30), decompensated cirrhosis with no or minimal ascites (Group B, n = 21), and decompensated cirrhosis with massive ascites (Group C, n = 19). Laboratory indicators were collected, and the Model for End-Stage Liver Disease (MELD) score was calculated. Liver shear stiffness (LSS) and relative liver enhancement (RLE) were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis assessed the role of LSS in detecting decompensated cirrhosis with no or minimal ascites. Multivariable logistic regression analysis identified factors associated with this condition.
The LSS in Group A (3.68 ± 0.20 kPa) was significantly lower than in Group B (5.95 ± 0.50 kPa) and Group C (6.27 ± 0.68 kPa) (both p < 0.001). The RLE in Group A (74.6%±4.5%) was significantly higher than in Group B (58.2%±5.1%) (p = 0.035) and Group C (43.5%±3.3%) (p < 0.001). ROC analysis indicated that LSS effectively differentiates between Group A and Group B (area under the ROC curve is 0.84, 95% confidence interval [CI]: 0.73-0.95). Multivariable analysis identified LSS as an independent risk factor for decompensated cirrhosis with no or minimal ascites.
MRE is a valuable tool for noninvasively guiding decompensation risk stratification in patients with varying volumes of ascites, particularly those with no or minimal ascites.
本研究旨在利用磁共振弹性成像（MRE）检测不同腹水量的肝硬化患者的失代偿情况。
我们前瞻性地回顾了70例接受三维MRE和钆塞酸增强磁共振成像（MRI）检查的肝硬化患者。根据临床信息和腹水量将患者分为三组：无腹水或少量腹水的代偿期肝硬化（A组，n = 30）、无腹水或少量腹水的失代偿期肝硬化（B组，n = 21）和大量腹水的失代偿期肝硬化（C组，n = 19）。收集实验室指标并计算终末期肝病模型（MELD）评分。测量并比较三组的肝脏剪切硬度（LSS）和相对肝脏强化（RLE）。采用受试者操作特征（ROC）曲线分析评估LSS在检测无腹水或少量腹水的失代偿期肝硬化中的作用。多变量逻辑回归分析确定与该情况相关的因素。
A组的LSS（3.68±0.20 kPa）显著低于B组（5.95±0.50 kPa）和C组（6.27±0.68 kPa）（均p < 0.001）。A组的RLE（74.6%±4.5%）显著高于B组（58.2%±5.1%）（p = 0.035）和C组（43.5%±3.3%）（p < 0.001）。ROC分析表明，LSS能有效区分A组和B组（ROC曲线下面积为0.84，95%置信区间[CI]：0.73 - 0.95）。多变量分析确定LSS是无腹水或少量腹水的失代偿期肝硬化的独立危险因素。
MRE是一种有价值的工具，可用于对不同腹水量的患者，特别是无腹水或少量腹水的患者进行无创性失代偿风险分层指导。
