摘要
目的：探讨磁共振弹性成像（MRE）评估慢性乙型肝炎患者纤维化程度的可重复性。方法：本院32例慢性乙型肝炎患者2次行肝脏常规MRI及MRE检查、且采用的MRE序列和扫描层面相同，所有患者在2个月内行肝脏穿刺活检证实有肝纤维化，其中轻度～中度纤维化（S1～S2）23例，中度～重度纤维化（S3～S4）9例。选择两次检查中对应的4个层面的解剖一弹性融合图，测量肝实质的弹性值。应用组内相关系数（ICC）及Bland-Altman方法评价两次扫描测量值的可重复性。采用Spearman检验分析患者肝纤维化分级与弹性值之间的相关性。结果：两次MRE检查中4个对应层面的肝脏平均弹性值的ICC值为0．923～O．956，肝脏最大弹性值的ICC值为0．761～0．893。轻度～中度纤维化患者两次检查测量的平均弹性值分别为（3．78±1．33）及（3．55±1．34）kPa，ICC值为0．909（95％CI：0．799～0．961）；中度～重度纤维化患者两次检查测量的平均弹性值分别为（5．07±lI94）及（4．87±2．01）kPa，ICC值为0．941（95％CI：0．861～0．976）。Bland-Altman方法显示不同层面测量的肝脏弹性值绝大多数位于95％置信区间内，提示可重复性良好。肝脏弹性值与肝纤维化程度呈显著正相关（P〈0．01）。结论：应用MRE对慢性乙型肝炎纤维化患者进行肝脏硬度评价的过程中其重复性良好。
Objective：To study the repeatability of magnetic resonance elastography （MRE） for evaluating hepatic fi- brosis. Methods：Thirty-two patients with hepatic fibrosis induced by HBV infection proved by liver biopsy were enrolled in this study,including 23 patients diagnosed as mild to moderate fibrosis （group A）,and 9 patients diagnosed as moderate to severe fibrosis （group B）. Each patient underwent twice MRI examinations using the same MRI and MRE sequences and scan levels. The time interval of MRI scan and liver biopsy was less than two months. Four corresponding slices from each MRE scan were selected and the liver stiffness （LS） was measured on the fusion images of stiffness map and anatomy image （T1WI）. Interclass correlation coefficient （ICC） was calculated and Bland-Altman analysis were used to evaluate the repeat- ability of LS. Results：The repeatability of average LS obtained from the two scans was high with ICC for the four slices was 0. 923-0. 956, and for the maximal LS, the repeatability was also high with ICC of different slices at 0. 761 - 0. 893. In group A,the average LS in the two scans was （3.78±1.33） and （3.55±1.34）kPa respectively,with ICC of 0. 909 （95% CI：0. 799-0. 961）. And in group B,the average LS in the two scan was （5.07±1.94） and （4.87±2.01）kPa,with ICC of 0. 941 （95%CI..0. 861-0. 976）. The Bland-Altman analysis also showed excellent agreement of LS between the two scan. There was strong correlation between the liver stiffness and the severity of fibrosis （P〈0.01）. Conclusion：MRE is a highly reproducible modality for evaluation of liver fibrosis.
出处
《放射学实践》
北大核心
2016年第8期752-755,共4页
Radiologic Practice
关键词
磁共振弹性成像
肝纤维化
可重复性
Magnetic resonance elastography
Liver fibrosis
Repeatability
