磁共振成像与瞬时弹性成像纤维扫描诊断肝纤维化的准确性比较

Ramsha Shahzeen, Zaeem Sibtain, N. Ahmed, Muhammad Affan Qaiser, Nazish Butt, Ghulam Muhammad
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摘要

目的:诊断肝纤维化不诉诸侵入性手术是高需求,但服务不足。本研究的重点是MRI和瞬时弹性成像纤维扫描对肝纤维化的诊断准确性。方法:经研究所审查委员会伦理批准后,采用随机抽样技术选择60例肝纤维化患者,进行多参数磁共振、经食管超声心动图(TE)和血液检测。非侵入性治疗方案与组织学信息进行权衡,包括分期和分级(如MR脂肪和铁含量)。采用ROC曲线分析评价各方法对F3、F4级肝纤维化及晚期肝纤维化的诊断准确性。根据准确度(F3-F4)对每种技术进行评估。结果:磁共振弹性成像发现纤维化分期与胶原含量有显著相关性(r = 0.66;P = 0.001),炎症等级与胶原蛋白含量之间也存在相关性(r = 0.53;P = 0.036)。MRE、TE、DCE-MRI、DWI和APRI的AUC均为0.78或以上,而识别晚期纤维化的AUC为0.71。晚期纤维化AUC值分别为0.94 ~ 0.77、0.79 ~ 0.79、0.70 ~ 0.70。(F3-F4)。实际意义:本研究将确定哪种诊断技术更适合准确诊断肝纤维化患者。结论:组织学指标与MRI的相关性最强。磁共振成像检测晚期肝纤维化和肝硬化的能力也优于瞬时弹性成像纤维扫描。关键词:MRI,肝纤维化,诊断准确性,瞬时弹性成像纤维扫描
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Comparison of Diagnostic Accuracy of Magnetic Resonance Imaging and Transient Elastography Fibro Scan for Detecting Liver Fibrosis
Objective: Diagnosing liver fibrosis without resorting to invasive surgery is in high demand but underserved. The focus of this study is on the diagnostic accuracy of MRI and the transient elastography fibro scan for liver fibrosis. Methodology: After the ethical approval from institute review board, sixty patients with liver fibrosis were selected by random sampling technique underwent multiparametric MR, transesophageal echocardiography (TE), and blood testing in this single-center cross-sectional study. Noninvasive treatment alternatives were weighed against histological information including stage and grade (such as MR fat and iron content). The diagnostic accuracy of each method for F3 and F4 hepatic fibrosis, as well as for advanced fibrosis, was evaluated using ROC curve analysis. Each technique was evaluated based on its accuracy (F3–F4). Results: Magnetic resonance elastography was used to find significant correlations between fibrosis stage and collagen content (r = 0.66; P = 0.001), as well as between inflammatory grade and collagen content (r = 0.53; P = 0.036). The MRE, TE, DCE-MRI, DWI, and APRI all had AUCs of 0.78 or above, while the AUC for identifying advanced fibrosis was 0.71. Advanced fibrosis AUC values were between 0.94 and 0.77, 0.79 and 0.79, and 0.70 and 0.70. (F3–F4). Practical implication: This study will to determine which diagnostic technique is better suited to accurately diagnose the liver fibrosis patients. Conclusion: The strongest correlation was seen between histological markers and MRI. The ability of magnetic resonance imaging to detect advanced liver fibrosis and cirrhosis was also superior to that of transient elastography fibro scans. Keywords: MRI, Liver fibrosis, diagnostic accuracy, transient elastography fibro scan
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