3.0T磁共振弹性成像评价非酒精性脂肪肝及预测脂性肝炎

Evaluation of non-alcoholic fatty liver disease and prediction of liver fibrosis by 3.0T magnetic resonance elastography

目的:探讨3.0T MR弹性成像(MRE)评价非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)患者肝纤维化的作用。方法:采用3.0T MRE分析20例健康志愿者(正常组)及57例肝脏活检诊断患有NAFLD的患者(病变组)的肝脏弹性值。采用受试者工作特征曲线(ROC)评价MRE鉴别NAFLD的诊断效能。结果:正常组及病变组的肝脏弹性值分别为(1.97±0.43)kPa及(4.05±1.70)kPa,二者间差异有统计学意义(t=-8.518,P<0.001);MRE诊断NAFLD≥F1、≥F2、≥F3及F4的ROC曲线下面积(AUC)均高于NAFLD纤维化分数(NFS),分别为0.92(NFS:0.74)、0.94(NFS:0.81)、0.95(NFS:0.85)、0.99(NFS:0.91)(AUC值比较P均<0.05)。结论:MRE是一种可靠的评价NAFLD患者纤维化分期的方法,优于血清学指标。

Objective: To investigate the effect of 3.0 T magnetic resonance elastography(MRE) on the evaluation of non-alcoholic fatty liver disease(NAFLD) patients and prediction the liver fibrosis. Methods: The preoperative liver stiffness of 20 healthy volunteers(normal group) and 57 patients(pathological group) diagnosed with NAFLD by liver biopsy were analyzed by 3.0 T MRE. Receiver operating characteristic curve(ROC) was used to evaluate the diagnostic efficacy of MRE in the staging liver fibrosis. Results: The shear stiffness of the normal group and the pathological group were(1.97±0.43) kPa and(4.05±1.70) kPa,with statistical significance(t=-8.518, P<0.001). The AUC of MRE for diagnosising ≥F1, ≥F2, ≥F3 and F4 liver fibrosis in NAFLD patients was 0.92, 0.94, 0.95 and 0.99, respectively, all of which were higher than that of NFS(0.74, 0.81, 0.85 and 0.91, respectively). Conclusion: MRE is a reliable tool for the evaluation of different stages of fibrosis in NAFLD patients.