AIM: To evaluate the correlation of shear wave elastography (SWE) results with liver fibrosis histology and quantitative function reserve. METHODS: Weekly subcutaneous injection of 60% carbon tetrachloride (1.5 mL/kg)...AIM: To evaluate the correlation of shear wave elastography (SWE) results with liver fibrosis histology and quantitative function reserve. METHODS: Weekly subcutaneous injection of 60% carbon tetrachloride (1.5 mL/kg) was given to 12 canines for 24 wk to induce experimental liver fibrosis, with olive oil given to 2 control canines. At 24 wk, liver condition was evaluated using clinical biochemistry assays, SWE imaging, lidocaine metabolite monoethylglycine-xylidide (MEGX) test, and histologic fibrosis grading. Clinical biochemistry assays were performed at the institutional central laboratory for routine liver function evaluation. Liver stiffness was measured in triplicate from three different intercostal spaces and expressed as mean liver stiffness modulus (LSM). Plasma concentrations of lidocaine and its metabolite MEGX were determined using high-performance liquid chromatography repeated in duplicate. Liver biopsy samples were fixed in 10% formaldehyde, and liver fibrosis was graded using the modified histological activity index Knodell score (F0-F4). Correlations among histologic grading, LSM, and MEGX measures were analyzed with the Pearson linear correlation coefficient. RESULTS: At 24 wk liver fibrosis histologic grading was as follows: F0, n = 2 (control); F1, n = 0; F2, n = 3; F3, n = 7; and F4, n = 2. SWE LSM was positively correlated with histologic grading (r = 0.835, P < 0.001). Specifically, the F4 group had a significantly higher elastic modulus than the F3, F2, and F0 groups (P = 0.002, P = 0.003, and P = 0.006, respectively), and the F3 group also had a significantly higher modulus than the control F0 group (P = 0.039). LSM was negatively associated with plasma MEGX concentrations at 30 min (r = -0.642; P = 0.013) and 60 min (r = -0.651; P = 0.012), time to 1/2 of the maximum concentration (r = -0.538; P = 0.047), and the area under the curve (r = -0.636; P = 0.014). Multiple comparisons showed identical differences in these three measures: significantly lower with F4 (P = 0.037) and F3 (P = 0.03展开更多
目的探究基于增强CT提取影像组学特征构建Nomogram无侵袭性评估肝纤维化分级的可行性。方法纳入郑州市人民医院2015年2月~2019年2月入院确诊为肝纤维化的患者,分为肝纤维化和早期肝硬化。以2018年2月为时间截点,将该时间点之前的入组患...目的探究基于增强CT提取影像组学特征构建Nomogram无侵袭性评估肝纤维化分级的可行性。方法纳入郑州市人民医院2015年2月~2019年2月入院确诊为肝纤维化的患者,分为肝纤维化和早期肝硬化。以2018年2月为时间截点,将该时间点之前的入组患者分为训练集,将该时间点之后的入组患者分为测试集,并基于患者增强CT图像提取影像组学特征。以患者是否肝纤维化或早期肝硬化为研究标签,对训练集患者采用最小冗余最大相关(mRMR)进行影像组学特征去冗除杂,继而采用套索算法(LASSO)构建影像组学标签(Radscore)。联合临床特征与Radscore构建临床影像联合模型评估肝纤维化分级。结果共计纳入91例,其中肝纤维化患者59例,早期肝硬化患者35例,基于门静脉期CT图像共计提取845个纹理特征,经过特征降维利用16个影像组学特征构建影像组学标签Radscore, Radscore鉴别训练集和测试集的患者是否肝纤维化或肝硬化早期的曲线下面积(AUC)为0.885 vs 0.932。继而基于训练集患者的临床特征联合Radscore构建多元逻辑回归模型评估患者是否肝纤维化或肝硬化早期,Nomogram可视化影像临床联合模型,训练集中Radscore的AUC高于临床影像模型高于临床指数[0.885 (95%CI:0.803~0.965) vs 0.881 (0.800~0.961) vs 0.672 (0.532~0.810)],测试集中临床影像模型的AUC高于Radscore高于临床指数[0.0.924 (0.812~0.1.000) vs 0.932 (0.821~0.993) vs 0.552 (0.315~0.783)]。Hosmer-Lemeshow分析提示联合模型与实际观察情况差异无统计学意义(P=0.8514)。结论基于门静脉期CT提取影像组学参数联合临床信息可用于无侵袭性评估肝纤维化分级,协助临床上针对不同患者制定个体化治疗方案。展开更多
基金Supported by National Natural Science Foundation of ChinaNo.81401425
文摘AIM: To evaluate the correlation of shear wave elastography (SWE) results with liver fibrosis histology and quantitative function reserve. METHODS: Weekly subcutaneous injection of 60% carbon tetrachloride (1.5 mL/kg) was given to 12 canines for 24 wk to induce experimental liver fibrosis, with olive oil given to 2 control canines. At 24 wk, liver condition was evaluated using clinical biochemistry assays, SWE imaging, lidocaine metabolite monoethylglycine-xylidide (MEGX) test, and histologic fibrosis grading. Clinical biochemistry assays were performed at the institutional central laboratory for routine liver function evaluation. Liver stiffness was measured in triplicate from three different intercostal spaces and expressed as mean liver stiffness modulus (LSM). Plasma concentrations of lidocaine and its metabolite MEGX were determined using high-performance liquid chromatography repeated in duplicate. Liver biopsy samples were fixed in 10% formaldehyde, and liver fibrosis was graded using the modified histological activity index Knodell score (F0-F4). Correlations among histologic grading, LSM, and MEGX measures were analyzed with the Pearson linear correlation coefficient. RESULTS: At 24 wk liver fibrosis histologic grading was as follows: F0, n = 2 (control); F1, n = 0; F2, n = 3; F3, n = 7; and F4, n = 2. SWE LSM was positively correlated with histologic grading (r = 0.835, P < 0.001). Specifically, the F4 group had a significantly higher elastic modulus than the F3, F2, and F0 groups (P = 0.002, P = 0.003, and P = 0.006, respectively), and the F3 group also had a significantly higher modulus than the control F0 group (P = 0.039). LSM was negatively associated with plasma MEGX concentrations at 30 min (r = -0.642; P = 0.013) and 60 min (r = -0.651; P = 0.012), time to 1/2 of the maximum concentration (r = -0.538; P = 0.047), and the area under the curve (r = -0.636; P = 0.014). Multiple comparisons showed identical differences in these three measures: significantly lower with F4 (P = 0.037) and F3 (P = 0.03
文摘目的探究基于增强CT提取影像组学特征构建Nomogram无侵袭性评估肝纤维化分级的可行性。方法纳入郑州市人民医院2015年2月~2019年2月入院确诊为肝纤维化的患者,分为肝纤维化和早期肝硬化。以2018年2月为时间截点,将该时间点之前的入组患者分为训练集,将该时间点之后的入组患者分为测试集,并基于患者增强CT图像提取影像组学特征。以患者是否肝纤维化或早期肝硬化为研究标签,对训练集患者采用最小冗余最大相关(mRMR)进行影像组学特征去冗除杂,继而采用套索算法(LASSO)构建影像组学标签(Radscore)。联合临床特征与Radscore构建临床影像联合模型评估肝纤维化分级。结果共计纳入91例,其中肝纤维化患者59例,早期肝硬化患者35例,基于门静脉期CT图像共计提取845个纹理特征,经过特征降维利用16个影像组学特征构建影像组学标签Radscore, Radscore鉴别训练集和测试集的患者是否肝纤维化或肝硬化早期的曲线下面积(AUC)为0.885 vs 0.932。继而基于训练集患者的临床特征联合Radscore构建多元逻辑回归模型评估患者是否肝纤维化或肝硬化早期,Nomogram可视化影像临床联合模型,训练集中Radscore的AUC高于临床影像模型高于临床指数[0.885 (95%CI:0.803~0.965) vs 0.881 (0.800~0.961) vs 0.672 (0.532~0.810)],测试集中临床影像模型的AUC高于Radscore高于临床指数[0.0.924 (0.812~0.1.000) vs 0.932 (0.821~0.993) vs 0.552 (0.315~0.783)]。Hosmer-Lemeshow分析提示联合模型与实际观察情况差异无统计学意义(P=0.8514)。结论基于门静脉期CT提取影像组学参数联合临床信息可用于无侵袭性评估肝纤维化分级,协助临床上针对不同患者制定个体化治疗方案。
