磁共振成像的比较准瞬态肝纤维化检测弹性和血清标志物

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,*

Article first published online: 7 FEB 2016

DOI: 10.1111/liv.13058

© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International


Volume 36, Issue 5, pages 659–666, May 2016
Article has an altmetric score of 2

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

* Correspondence
Bachir Taouli, MD, Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029, USA
e-mail: [email protected]

    SLF and BT: Co-last authors

    Handling Editor: Frank Tacke

   
Keywords:

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

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

In this single centre 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

Magnetic resonance elastography 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 and APRI, respectively. For detection of advanced fibrosis (F3–F4), AUCs were 0.94, 0.77, 0.79, 0.79 and 0.70, respectively.
Conclusions

Magnetic resonance elastography 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.

StephenW

磁共振成像的比较准瞬态肝纤维化检测弹性和血清标志物

    Hadrien A. Dyvorne1，圭多H. Jajamovich1，明锐Bane1，M.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，*

文章首次在线发表时间：2016年2月7日

DOI：10.1111 / liv.13058

2016年©约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际


第36卷，第5期，页659-666，2016年5月
制品具有为2的altmetric得分

    1平移与分子影像研究所，西奈山伊坎医学院，纽约，NY，USA
    病理学系，西奈山伊坎医学院，纽约，NY，USA
    医学系3，肝病科，医学，纽约，纽约州，美国西奈山医学院
    放射科，纽约大学Langone医学中心，纽约，纽约，美国的4部
    放射科5，西奈山伊坎医学院，纽约，NY，USA

*通讯
贝希尔Taouli医师，放射科和转化与分子影像研究所，西奈山伊坎医学院，1470麦迪逊大道，纽约，NY 10029，USA系
电子邮件：[email protected]

    SLF和BT：合作最后作者

    处理编辑：弗兰克·塔克

   
关键词：

    弥散加权成像;动态对比增强MRI;弹性成像;肝纤维化;磁共振成像

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的未满足的需要。这里，我们评估包括扩散加权成像（DWI），动态对比增强与瞬时弹性比较（DCE）-MRI和磁共振弹性（MRE）（TE）多参数磁共振成像（MRI）的协议的诊断价值和血液化验[包括ELF（增强肝纤维化）和APRI]肝纤维化检测。
方法

在这种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MRI多参数（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源性脂肪和铁含量。 ROC曲线分析评估每种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

磁共振弹性设置有纤维化分期相关（r = 0.66，P <0.001），炎症等级相关（r = 0.52，P <0.001）和胶原蛋白含量相关（r = 0.53，p = 0.036）相关性最强。对于检测中至晚期纤维化（F2-F4）的，分别的AUC 0.78，0.82，0.72，0.79，0.71 MRE，TE，DCE-MRI，DWI分别APRI和。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分别和0.70。
结论

磁共振弹性提供了组织病理学标志物的相关性最高，并产生用于检测晚期肝纤维化和肝硬化高诊断性能，相比DWI，DCE-MRI，TE和血清标志物。