慢性乙型肝炎肝纤维化的诊断和分期;磁共振弹性

StephenW

Source: Eur Radiol  |  Posted 2 days ago
Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B; Venkatesh S, Wang G, Lim S, Wee A; European Radiology (Aug 2013)

   
OBJECTIVES We measured the accuracy of magnetic resonance elastography (MRE) for the detection and staging of liver fibrosis in chronic hepatitis B (CHB) and compared it with serum fibrosis markers.

METHODS Prospective comparison of MRE and routine serum fibrosis markers, namely serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), ALT/AST ratio (AAR), AST to platelet ratio index (APRI) and prothrombin index (PI), was performed in 63 consecutive CHB patients who underwent MRE and histological confirmation of liver fibrosis within a 6-month interval. Diagnostic performance of MRE and serum markers for staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4) was compared.

RESULTS The study group comprised 63 patients (19 female; mean age ± SD, 50 ± 11.9 years). MRE (ρ = 0.94, P < 0.0001), APRI (ρ = 0.42, P = 0.0006), PI (ρ = 0.42, P = 0.0006) and AST (ρ = 0.28, P = 0.028) results correlated significantly with fibrosis stage. MRE was significantly more accurate than serum fibrosis markers for the detection of significant fibrosis (0.99 vs. 0.55-0.73) and cirrhosis (0.98 vs. 0.53-0.77). Sensitivity, specificity, positive predictive and negative predictive values for MRE for significant fibrosis and cirrhosis were 97.4 %, 100 %, 100 % and 96 %, and 100 %, 95.2 %, 91.3 % and 100 %, respectively.

CONCLUSION MRE is an accurate non-invasive technique for the detection and staging of liver fibrosis in CHB.

KEY POINTS • Magnetic resonance elastography is accurate for liver fibrosis detection and staging. • MR elastography is more accurate than serum tests for staging liver fibrosis. • MR elastography can potentially replace liver biopsy in chronic hepatitis B.

StephenW

目标测量磁共振弹性成像（MRE）的慢性乙型肝炎（CHB）肝纤维化的诊断和分期的准确性相比，它与血清肝纤维化标志物。

方法前瞻性比较麦格理和常规血清纤维化指标，即血清谷丙转氨酶（ALT），血清谷草转氨酶（AST），ALT / AST比值（AAR），AST与血小板比值指数（APRI）和凝血酶原指数（PI），在连续63例慢性乙型肝炎患者接受麦格理和组织学证实肝纤维化的6个月的时间间隔内进行。 MRE和纤维化分期（≥F1），显着性纤维化（≥F2），先进的纤维化（≥F3），肝硬化（F4）的血清标志物的诊断性能进行了比较。

结果研究组包括63例患者（女19例，平均年龄±SD，50±11.9岁）。麦格理（ρ= 0.94，P <0.0001），APRI（ρ= 0.42，P = 0.0006），PI（ρ= 0.42，P = 0.0006）和AST（ρ= 0.28，P = 0.028），结果显着相关，与肝纤维化阶段。 MRE是显着更准确比血清纤维化指标的检测显着的纤维化（0.99对比0.55-0.73），肝硬化（0.98对比0.53-0.77）。灵敏度，特异度，阳性预测阴性预测值分别为97.4％，100％，100％和96％，100％，95.2％，91.3％和100％，显着的纤维化，肝硬化的MRE。

结论MRE是一个准确的非侵入性技术，在慢性乙型肝炎肝纤维化的诊断和分期。

要点•磁共振弹性是准确的肝纤维化诊断和分期。 •MR弹性成像血清肝纤维化分期测试更准确。 •MR弹性成像有可能取代肝穿刺活检在慢性乙型肝炎

StephenW

Magnetic resonance elastography (MRE) is a non-invasive medical imaging technique that measures the mechanical properties (stiffness) of soft tissues by introducing shear waves and imaging their propagation using MRI. Pathological tissues are often harder than the surrounding normal tissue, for instance, malignant breast tumors are much harder than healthy fibro-glandular tissue. This characteristic has been used by physicians for screening and diagnosis of many diseases, through Palpation. MRE calculates the mechanical parameter as elicited by palpation, in a non-invasive and objective way.
磁共振弹性成像（MRE）是一种非侵入性的医疗成像技术，测量软组织的机械性能（刚度）通过引入剪切波和用MRI成像其传播。病理组织往往比周围正常组织更难，例如，恶性乳腺肿瘤比健康纤维腺体组织更难。这一特性已被用于许多疾病的筛查和诊断医师，透过触诊。麦格理计算力学参数，通过触诊引起，在一个非侵入性和客观的方式。

MP4

哪家公司的产品

StephenW

回复 MP4 的帖子

我认为它仍然是一个发展中的技术.

MP4

看了，也是梅奥诊所的