磁共振成像质子密度脂肪分数评估非酒精性脂肪性肝病患者肝脏脂肪变性临床价值研究*

doi:10.3969/j.issn.1672-5069.2025.05.016

实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (5): 703-706.doi: 10.3969/j.issn.1672-5069.2025.05.016

磁共振成像质子密度脂肪分数评估非酒精性脂肪性肝病患者肝脏脂肪变性临床价值研究^*

葛天明, 吴启源, 于小伟, 李冠武

201800 上海市嘉定区中医医院放射科(葛天明,吴启源);肿瘤科(于小伟);上海中医药大学附属岳阳中西医结合医院放射科(李冠武)

收稿日期:2024-12-25 出版日期:2025-09-10 发布日期:2025-09-19
通讯作者: 吴启源,E-mail:wuqiyuan80@163.com
作者简介:葛天明,男,45岁,大学本科,主治医师。E-mail:ge1688688@126.com
基金资助:
*上海市中医优势病种培育项目(编号:zybz-2017054)

Verification of magnetic resonance imaging proton density fat fraction in predicting liver steatosis in patients with nonalcoholic fatty liver disease

Ge Tianming, Wu Qiyuan, Yu Xiaowei, et al

Department of Radiology, Jiading District Traditional Chinese Medicine Hospital, Shanghai 201800,China

Received:2024-12-25 Online:2025-09-10 Published:2025-09-19

摘要/Abstract

摘要： 目的探讨应用磁共振成像质子密度脂肪分数(MRI-PDFF)评估非酒精性脂肪性肝病(NAFLD)患者肝脏脂肪变性的价值。方法 2022年12月～2023年12月我院诊治的96例NAFLD患者和同期健康人55例,使用MRI检查测定MRI-PDFF,使用瞬时弹性成像行肝硬度检测(LAM)和受控衰减参数(CAP)。所有NAFLD患者接受肝活检检查。结果 NAFLD患者MRI-PDFF、CAP和LSM分别为(27.5±9.6)%、(297.2±35.2)dB/m和(10.3±2.3)kPa,均显著高于健康人【分别为(9.8±3.3)%、(251.7±14.4)dB/m和(5.1±1.3)kPa,P<0.05】;16例重度肝脂肪变组LSM、CAP和MRI-PDFF分别为(11.8±2.0)kPa、(341.1±32.2)dB/m和(37.3±8.3)%,均显著高于29例中度组【分别为(10.4±1.8)kPa、(284.0±12.7)dB/m和(25.1±3.4)%,P<0.05】或51例轻度组【分别为(8.9±1.7)kPa、(263.5±7.7)dB/m和(14.4±3.2)%,P<0.05】;经ROC分析显示,以MRI-PDFF大于或等于31.4%为截断点,评估NAFLD患者重度肝脏脂肪变性的AUC为0.903,其敏感性为87.5%,特异性为93.1%(P<0.05)。结论应用MRI-PDFF判断NAFLD患者肝脏脂肪变性具有很大的临床价值,可以指导临床监测。

关键词: 非酒精性脂肪性肝病, 肝脂肪变性, 磁共振成像质子密度脂肪分数, 诊断

Abstract: Objective The aim of this study was to investigate magnetic resonance imaging proton density fat fraction (MRI-PDFF) in predicting liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods 96 patients with NAFLD and 55 healthy volunteers were enrolled in our hospital between December 2022 and December 2023, and all underwent MRI scan for MRI-PDFF measurement. Liver stiffness measurement (LSM) AND controlled attenuation parameter (CAP) were detected by transient elastography. Liver biopsy was performed in patients with NAFLD. Results MRI-PDFF, CAPand LSM in patients with NAFLD were (27.5±9.6)%,(297.2±35.2)dB/m and (10.3±2.3)kPa, all significantly higher than [(9.8±3.3)%, (251.7±14.4)dB/m and (5.1±1.3)kPa, respectively, P<0.05] in healthy persons; LSM,CAPand MRI-PDFF in 16 patients with histology-proven severe liver steatosis were (11.8±2.0)kPa, (341.1±32.2)dB/m and (37.3±8.3)%, all significantly higher than [(10.4±1.8)kPa, (284.0±12.7)dB/m and (25.1±3.4)%, respectively, P<0.05] in 29 patients with moderate liver steatosis or [(8.9±1.7)kPa, (263.5±7.7)dB/m and (14.4±3.2)%, respectively, P<0.05] in 51 patients with mild liver steatosis; ROC analysis showed that the AUC was 0.903, with sensitivity of 87.5% and specificity of 93.1%(P<0.05), when MRI-PDFF equal to or greater than 31.4% was set as the cut-off-value in predicting severe liver steatosis in patients with NAFLD. Conclusion Utility of MRI-PDFF could help clinicians for surveillance of liver steatosis in patients with NAFLD in clinical practice, especially for dynamic evaluation in process of intervention.

Key words: Nonalcoholic fatty liver disease, Liver steatosis, Magnetic resonance imaging proton density fat fraction, Diagnosis

葛天明, 吴启源, 于小伟, 李冠武. 磁共振成像质子密度脂肪分数评估非酒精性脂肪性肝病患者肝脏脂肪变性临床价值研究^*[J]. 实用肝脏病杂志, 2025, 28(5): 703-706.

Ge Tianming, Wu Qiyuan, Yu Xiaowei, et al. Verification of magnetic resonance imaging proton density fat fraction in predicting liver steatosis in patients with nonalcoholic fatty liver disease[J]. Journal of Practical Hepatology, 2025, 28(5): 703-706.

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磁共振成像质子密度脂肪分数评估非酒精性脂肪性肝病患者肝脏脂肪变性临床价值研究^*

Verification of magnetic resonance imaging proton density fat fraction in predicting liver steatosis in patients with nonalcoholic fatty liver disease

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