磁共振成像的前瞻性比较瞬时弹性成像及血清标志物肝纤维

StephenW

Prospective comparison of magnetic resonance imaging to transient elastography and serum markers for liver fibrosis detection

    Hadrien A. Dyvorne1, Guido H. Jajamovich1, Octavia Bane1, M. Isabel Fiel2, Hsin Chou3, Thomas D. Schiano3, Douglas Dieterich3, James S. Babb4, Scott L. Friedman3 andBachir Taouli1,5,*

DOI: 10.1111/liv.13058

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Liver International

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Author Information

    1    Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York,, New York, USA
    2    Department of Pathology, Icahn School of Medicine at Mount Sinai, New York,, New York, USA
    3    Department of Medicine, Icahn School of Medicine at Mount Sinai, New York,, New York, USA
    4    Department of Radiology, New York University Langone Medical Center, New York, NY
    5    Department of Radiology, Icahn School of Medicine at Mount Sinai, New York,, New York, USA

* Correspondence author
Bachir Taouli, MD
Icahn School of Medicine at Mount Sinai
Department of Radiology and Translational and Molecular Imaging Institute
1470 Madison Ave, New York, NY 10029, USA
Tel: + 1 212 824-8453
Email: [email protected]

   
Keywords:

    liver fibrosis;magnetic resonance imaging;elastography; DWI ;dynamic contrast-enhanced MRI

Abstract
Background & Aims

Establishing accurate non-invasive methods of liver fibrosis quantification remains a major unmet need. Here, we assessed the diagnostic value of a multiparametric magnetic resonance imaging (MRI) protocol including diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE)-MRI and magnetic resonance elastography (MRE) in comparison with transient elastography (TE) and blood tests [including ELF (Enhanced Liver Fibrosis) and APRI] for liver fibrosis detection.
Methods

n this single center cross-sectional study, we prospectively enrolled 60 subjects with liver disease who underwent multiparametric MRI (DWI, DCE-MRI and MRE), TE and blood tests. Correlation was assessed between non-invasive modalities and histopathologic findings including stage, grade, and collagen content, while accounting for covariates such as age, sex, BMI, HCV status and MRI-derived fat and iron content. ROC curve analysis evaluated the performance of each technique for detection of moderate-to-advanced liver fibrosis (F2-F4) and advanced fibrosis (F3-F4).
Results

MRE provided the strongest correlation with fibrosis stage (r=0.66, p <0.001), inflammation grade (r=0.52, p <0.001) and collagen content (r=0.53, p=0.036). For detection of moderate-to-advanced fibrosis (F2-F4), AUCs were 0.78, 0.82, 0.72, 0.79, 0.71 for MRE, TE, DCE-MRI, DWI, APRI, respectively. For detection of advanced fibrosis (F3-F4), AUCs were 0.94, 0.77, 0.79, 0.79, 0.70, respectively
Conclusions

MRE provides the highest correlation with histopathologic markers and yields high diagnostic performance for detection of advanced liver fibrosis and cirrhosis, compared to DWI, DCE-MRI, TE and serum markers

This article is protected by copyright. All rights reserved.

StephenW

磁共振成像的前瞻性比较瞬时弹性成像及血清标志物肝纤维化检测Hadrien A. Dyvorne1，圭多H. Jajamovich 1，明锐Bane1，米伊莎贝尔Fiel2，心Chou3，托马斯D. Schiano3，道格拉斯Dieterich3，詹姆斯S Babb4斯科特L. Friedman3 andBachir Taouli1,5，*
DOI：10.1111 / liv.13058
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封面图片卷。 36第1期
肝国际
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作者信息
出版历史
作者信息1转化和分子影像研究所，西奈山伊坎医学院，纽约,,纽约，病理美国2系，西奈山伊坎医学院，纽约,,纽约，医学美国3系，西奈山伊坎医学院，纽约,,纽约，放射学美国4部，纽约大学朗格尼医学中心，纽约，纽约5放射科，西奈山伊坎医学院，纽约,,纽约州，美国
*通讯作者
贝希尔Taouli，MD
西奈山伊坎医学院
放射学和转化和分子成像研究所系
1470麦迪逊大道，纽约，NY 10029，USA
电话：+ 1 212 824-8453
电子邮件：[email protected]
关键词：肝纤维化;磁共振成像;弹性; DWI，动态对比增强MRI
抽象
背景和目的
建立肝纤维化定量准确的非侵入性的方法仍然是一个重大未满足的需要。在这里，我们评估了多参数的磁共振成像（MRI）的协议，包括弥散加权成像（DWI），动态对比增强（DCE）-MRI和磁共振弹性（MRE）与瞬时弹性比较（TE）的诊断价值和血液化验[包括ELF（增强肝纤维化）和APRI对于肝纤维化的检测。
方法
n这个单中心横断面研究中，我们前瞻性纳入60例肝病患者谁接受多参数MRI（DWI，DCE-MRI和MRE），TE和验血。相关性的非侵入性的方式和组织病理学结果包括分期，分级，和胶原蛋白含量之间分摊，而占协变量，例如年龄，性别，BMI，丙型肝炎病毒的状态和MRI源性脂肪和铁的含量。 ROC曲线分析评价各技术检测中度至晚期肝纤维化（F2-F4）和晚期肝纤维化（F3-F4）的性能。
结果
MRE设置有纤维化阶段相关（r = 0.66，P <0.001），炎症分级性（r = 0.52，P <0.001）和胶原蛋白含量相关（r = 0.53，p值= 0.036）相关性最强。对于检测中至晚期纤维化（F2-F4）的，的AUC分别为0.78，0.82，0.72，0.79，0.71 MRE，TE，DCE-MRI，DWI，APRI分别。为了检测晚期肝纤维化（F3-F4）的AUC分别为0.94，0.77，0.79，0.79，0.70，分别
结论
MRE提供了组织病理学标记和检测的晚期肝纤维化和肝硬化的产量高诊断性能最高相关，相比DWI，DCE-MRI，TE和血清标记物
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MP4

最早知道梅奥诊所有，不过MRE价格估计很贵，FT机带B超才90人民币.MRI则要300，加显影剂1000。