应用MRI多回波水脂分离技术评估代谢相关性脂肪性肝病患者肝脏脂肪含量的临床意义

doi:10.3969/j.issn.1672-5069.2021.02.018

实用肝脏病杂志 ›› 2021, Vol. 24 ›› Issue (2): 220-223.doi: 10.3969/j.issn.1672-5069.2021.02.018

应用MRI多回波水脂分离技术评估代谢相关性脂肪性肝病患者肝脏脂肪含量的临床意义

徐春玲, 苗重昌, 刘雨成, 张雪, 史曙光, 李树芸

222061 江苏省连云港市徐州医科大学附属连云港市第一人民医院影像科

收稿日期:2020-11-11 出版日期:2021-03-10 发布日期:2021-04-30
作者简介:徐春玲,女,43岁,大学本科,主治医师。E-mail:xuchunling25681@163.com
基金资助:
江苏省自然科学基金资助项目(编号:2019437)

Clinicalimplications of MRI multi-echo dixon technique in diagnosing hepatic steatosis in patients with metabolic associated fatty liver disease

Xu Chunling, Miao Chongchang, Liu Yucheng, et al

Department of Radiology, First People's Hospital, Affiliated to Xuzhou Medical University, Lianyungang 222061,Jiangsu Province, China

Received:2020-11-11 Online:2021-03-10 Published:2021-04-30

摘要/Abstract

摘要： 目的探讨运用MRI多回波水脂分离技术评估代谢相关性脂肪性肝病(MAFLD)患者肝脏脂肪含量的效能。方法 2018年6月～2019年10月我院收治的MAFLD患者97例和同期健康体检者46例,接受MR检查,应用MRI多回波水脂分离技术检测肝脂肪分数(FF),对MAFLD患者常规行肝穿刺活检,应用受试者工作特征曲线(ROC)分析FF诊断肝脏脂肪变性程度的效能。结果 MAFLD组BMI、ALT、AST、TG、TC和FF分别为(26.3±3.1)kg/m²、(85.6±5.4)U/L、(76.5±4.9)U/L、(3.2±1.0)mmol/L、(7.4±1.2)mmol/L和(23.7±5.3)%,显著高于健康人【分别为(23.2±2.2) kg/m²、(28.3±3.5) U/L、(26.5±4.1)U/L、(1.5±0.4)mmol/L、(3.9±0.8)mmol/L和(10.3±3.9)%,P<0.05】;28例中度组和18例重度组FF分别为(25.3±5.5)%和(44.7±6.7)%,与51例轻度组比,差异显著【(15.5±4.0)%,P<0.05】;以FF分别等于16.4%、26.4%和44.6%为截断点,其诊断轻度、中度和重度肝脏脂肪变性的ROC曲线下面积(AUC)分别为0.728(95%CI:0.628～0.829)、0.870(95%CI:0.784～0.957)和0.996(95%CI:0.985～1.000)。结论 MRI多回波水脂分离技术对诊断和区分MAFLD患者肝脏脂肪变性严重程度具有较高的效能。

Abstract: Objective The purpose of this study was to explore the clinical implications of magnetic resonance imaging multi-echo dixon technique in diagnosing hepatic steatosis in patients with metabolic associated fatty liver disease (MAFLD). Methods 97 MAFLD patients and 46 healthy persons were enrolled in this study between June 2018 and October 2019, and the proton density fat fraction (PDFF) was detected by MRI ME Dixon technique. All patients with MAFLD underwent routine liver biopsies. The diagnostic efficacy of MRI-PDFF for severity of liver steatosis was analyzed by receiver operating characteristic (ROC) curves. Results The BMI, serum ALT, AST, TG and TC levels as well as fat fraction (FF) in patients with MAFLD were (26.3±3.1)kg/m², (85.6±5.4)U/L, (76.5±4.9)U/L, (3.2±1.0)mmol/L, (7.4±1.2)mmol/L and (23.7±5.3)%, all significantly higher than 【(23.2±2.2) kg/m²,(28.3±3.5) U/L,(26.5±4.1)U/L,(1.5±0.4)mmol/L,(3.9±0.8)mmol/L and (10.3±3.9)%, respectively, P<0.05】 in the control; the FF in 28 patients with moderate and in 18 patients with severe hepatic steatosis were (25.3±5.5)% and (44.7±6.7)%, both significantly higher than 【(15.5±4.0)%, P<0.05】 in 51 patients with mild hepatic steatosis; the area under receiver operating characteristic curve (AUC) of FF in diagnosing mild, moderate and severe hepatic steatosis were0.728(95%CI:0.628-0.829), 0.870(95%CI:0.784-0.957) and 0.996(95%CI:0.985-1.000), when 16.4%, 26.4% and 44.6% was set as the cut-off-value.Conclusion MRI multi-echo dixon technique is of importance in diagnosing hepatic steatosis in patients with MAFLD, which warrants further investigation.

Key words: Metabolic associated fatty liver disease, Magnetic resonance imaging, Multi-echo dixon technique, Hepatic steatosis, Diagnosis

徐春玲, 苗重昌, 刘雨成, 张雪, 史曙光, 李树芸. 应用MRI多回波水脂分离技术评估代谢相关性脂肪性肝病患者肝脏脂肪含量的临床意义[J]. 实用肝脏病杂志, 2021, 24(2): 220-223.

Xu Chunling, Miao Chongchang, Liu Yucheng, et al. Clinicalimplications of MRI multi-echo dixon technique in diagnosing hepatic steatosis in patients with metabolic associated fatty liver disease[J]. Journal of Practical Hepatology, 2021, 24(2): 220-223.

参考文献

[1] 薛芮, 范建高. 代谢相关脂肪性肝病新定义的国际专家共识简介.临床肝胆病杂志, 2020, 36(6):34-37.
[2] Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol, 2020, 73(1):202-209.
[3] Sharma P, Kumar A. Metabolic dysfunction associated fatty liver disease increases risk of severe Covid-19. Diabetes Metab Syndr, 2020, 4(5):825-827.
[4] Xu Z, Li H, Tian S, et al. Blood biomarkers for the diagnosis of hepatic steatosis in metabolic dysfunction-associated fatty liver disease. J Hepatol, 2020, 73(5):1264-1265.
[5] Hu F, Yang R, Huang Z, et al. 3Dmulti-echo dixon technique for simultaneous assessment of liver steatosis and iron overload in patients with chronic liver diseases: a feasibility study. Quant Imaging Med Surg, 2019, 9(6):1014-1024.
[6] Zhan C, Olsen S, Zhang HC, et al. Detection of hepatic steatosis and iron content at 3 Tesla: comparison of two-point Dixon, quantitative multi-echo Dixon, and MR spectroscopy. Abdom Radiol (NY), 2019, 44(9):3040-3048.
[7] Serai SD, Smith EA, Trout AT, et al. Agreement between manual relaxometry and semi-automated scanner-based multi-echo Dixon technique for measuring liver T2 in a pediatric and young adult population. Pediatr Radiol, 2018, 48(1):94-100.
[8] 中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪肝专家委员会.非酒精性脂肪性肝病防治指南 (2018年版).实用肝脏病杂志,2018,21(2):177-186.
[9] Trefts E, Gannon M, Wasserman DH. The liver. Curr Biol, 2017,27(21):R1147-R1151.
[10] Almazroo OA, Miah MK,Venkataramanan R. Drug metabolism in the liver. Clin Liver Dis, 2017, 21(1):1-20.
[11] Ismaiel A, Dumitrascu DL. Genetic predisposition in metabolic-dysfunction-associated fatty liver disease and cardiovascular outcomes-Systematic review. Eur J Clin Invest, 2020, 50(10):e13331.
[12] Gu Z, Bi Y, Yuan F, et al. FTO Polymorphisms are associated with metabolic dysfunction-associated fatty liver disease (MAFLD) Susceptibility in the older chinese han population. Clin Interv Aging, 2020, 15:1333-1341.
[13] Smith A, BaumgartnerK, Bositis C. Cirrhosis: Diagnosis and management. Am Fam Physic, 2019, 100(12):759-770.
[14] Castera L, Friedrich-Rust M, Loomba R. Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology, 2019, 156(5):1264-1281.
[15] Younossi ZM. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol, 2019, 70(3):531-544.
[16] 邵幼林,范建高.非酒精性脂肪性肝病的流行现状与危害.中华肝脏病杂志,2019,27(1):10-13.
[17] Jennison E, Patel J, Scorletti E, et al. Diagnosis and management of non-alcoholic fatty liver disease. Postgrad Med J, 2019, 95(1124):314-322.
[18] Lugauer F, Nickel D, Wetzl J, et al. Accelerating multi-echo water-fat MRI with a joint locally low-rank and spatial sparsity-promoting reconstruction. MAGMA, 2017, 30(2):189-202.
[19] Tang A, Tan J, Sun M, et al. Nonalcoholic fatty liver disease: MR imaging of liver proton density fat fraction to assess hepatic steatosis. Radiology, 2013, 267: 422-431.
[20] Middleton MS, Van Natta ML, Heba ER, et al. Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease. Hepatology, 2018, 67:858-872.

应用MRI多回波水脂分离技术评估代谢相关性脂肪性肝病患者肝脏脂肪含量的临床意义

Clinicalimplications of MRI multi-echo dixon technique in diagnosing hepatic steatosis in patients with metabolic associated fatty liver disease

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	贾群玲, 徐志宾, 韩舒. 非酒精性脂肪性肝病患者磁共振质子密度脂肪分数变化[J]. 实用肝脏病杂志, 2021, 24(3): 359-362.
[2]	刘彦荣, 王苗, 曾果, 许晓亮. MRI弥散加权成像对原发性硬化性胆管炎患者肝纤维化评估价值分析[J]. 实用肝脏病杂志, 2021, 24(3): 375-378.
[3]	南东, 洪金玲, 姜海宇. 应用DCE-MRI技术评估乙型肝炎肝硬化患者食管胃底静脉曲张严重程度的效能分析[J]. 实用肝脏病杂志, 2021, 24(3): 407-410.
[4]	王耀政, 王瑜琳, 林毅. F-FDG PET/CT诊断胆管细胞癌分期价值研究[J]. 实用肝脏病杂志, 2021, 24(3): 427-430.
[5]	干艳英, 钟凯, 官燕玲, 李慧敏. 三种影像学方法诊断肝外胆管结石比较研究[J]. 实用肝脏病杂志, 2021, 24(3): 439-442.
[6]	韩文有, 李向军, 赵森峰, 徐俊梅, 刘博. 术前胆汁CT值测定诊断胆囊泥沙样结石的应用价值分析[J]. 实用肝脏病杂志, 2021, 24(3): 443-446.
[7]	朱琳, 秦刚. 妊娠特有肝病诊治进展[J]. 实用肝脏病杂志, 2021, 24(3): 449-452.
[8]	白洁, 郑素军. 重视和推进对遗传代谢性肝病的认识和研究[J]. 实用肝脏病杂志, 2021, 24(2): 153-155.
[9]	张思薇, 孔银, 刘天府, 刘元元, 麻爱娣, 李永芳, 李娟, 张岭漪. 肝脏硬度检测联合吲哚菁绿滞留率测定对血清转氨酶正常或轻度升高的慢性乙型肝炎患者肝组织学病变进展的预测价值[J]. 实用肝脏病杂志, 2021, 24(2): 184-187.
[10]	代海峰, 王甜, 雷迅, 蔡佳, 黄文祥. 应用瞬时弹性成像技术联合APRI和AAR指数评估慢性乙型肝炎患者肝纤维化临床价值研究[J]. 实用肝脏病杂志, 2021, 24(2): 196-199.
[11]	杨振辉, 古宝欢, 戴小灵. 非酒精性脂肪性肝炎患者肝脏受控衰减参数的变化[J]. 实用肝脏病杂志, 2021, 24(2): 212-215.
[12]	王若宇, 伍玉南, 唐丹. 血浆Ki67联合miRNA-26b检测诊断肝细胞癌价值分析[J]. 实用肝脏病杂志, 2021, 24(2): 264-267.
[13]	代小兵, 刘启榆, 吴俊辉. 磁共振增强扫描弥散加权成像对肝脏良恶性肿瘤的鉴别诊断价值研究[J]. 实用肝脏病杂志, 2021, 24(2): 268-271.
[14]	陈姣姣, 何年安, 房静, 叶显俊, 胡蕾, 王磊. 常规超声和超声造影检查诊断肝内胆管细胞癌[J]. 实用肝脏病杂志, 2021, 24(2): 272-275.
[15]	宋斌, 赵厚亮, 叶莉. 三维磁共振胰胆管成像诊断小儿胆道闭锁价值分析[J]. 实用肝脏病杂志, 2021, 24(2): 288-291.