基于MRI水脂分离检测肝脏质子密度脂肪分数评估NAFLD患者脂肪变性程度应用研究*

doi:10.3969/j.issn.1672-5069.2026.01.016

摘要/Abstract

摘要： 目的分析基于磁共振成像(MRI)水脂分离技术定量检测非酒精性脂肪性肝病(NAFLD)患者肝脏质子密度脂肪分数(PDFF)诊断肝脂肪变性程度的应用价值。方法 2022年5月~2025年5月我院收治的106例NAFLD患者和30例体检健康人,均接受MRI 水脂分离序列(FACT 技术)检测肝脏PDFF,NAFLD患者接受肝穿刺活检。应用受试者工作特征曲线(ROC)评估PDFF诊断NAFLD患者中重度肝脂肪变性的效能。结果组织病理学检查诊断轻度脂肪变性56例,中度脂肪变性33例和重度脂肪变性17例;NAFLD组PDFF为(19.1±2.0)%,显著大于健康人组【(6.8±0.7)%,P<0.05】;重度脂肪变性组血清TG、TC、LDL-C和PDFF分别为(5.1±0.6)mmol/L、(6.6±0.8)mmol/L、(3.7±0.5)mmol/L和(24.3±2.6)%,均显著高于轻度脂肪变性组【分别为(2.1±0.3)mmol/L、(5.5±0.6)mmol/L、(3.1±0.4)mmol/L和(17.0±1.8)%,P<0.05】或中度脂肪变性组【分别为(4.0±0.4)mmol/L、(6.2±0.7)mmol/L、(3.4±0.4)mmol/L和(20.1±2.1)%,P<0.05】,而血清HDL-C水平为(0.8±0.1)mmol/L,显著低于轻度脂肪变性组【(1.3±0.2)mmol/L,P<0.05】或中度脂肪变性组【(1.0±0.1)mmol/L,P<0.05】;ROC分析表明,以18.8%为截断点,PDFF诊断中重度NAFLD的AUC为0.865,其约登指数为0.568,敏感度为80.0%,特异性为76.8%。结论基于MRI FACT 技术检测的PDFF诊断NAFLD患者中重度脂肪变性具有一定的临床应用价值。

关键词: 非酒精性脂肪性肝病, 肝脂肪变性, 磁共振成像, 多回波水脂分离技术, 质子密度脂肪分数, 诊断

Abstract: Objective The aim of this study was to analyze the diagnostic performance of liver quantitative parameters, proton density fat fraction (PDFF) obtained by magnetic resonance imaging (MRI) water-lipid separation in predicting liver steatosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 106 patients with NAFLD and 30 healthy individuals were enrolled in our hospital between May 2022 and May 2025, all underwent MRI fat analysis calculation technique (FACT) to detect PDFF of the liver, and all patients with NAFLD received liver biopsy. The diagnostic efficacy of PDFF was evaluated by receiver operating characteristic (ROC) curves. Results Liver histo-pathological examination found mild liver steatosis in 56 cases, moderate in 33 cases and severe in 17 cases; PDFF in patients with NAFLD was (19.1±2.0)%, much higher than [(6.8±0.7)%, P<0.05] in healthy control; serum triglyceride, total cholesterol, low-density lipoprotein cholesterol levels and PDFF in patients with severe liver steatosis were (5.1±0.6)mmol/L, (6.6±0.8)mmol/L, (3.7±0.5)mmol/L and (24.3±2.6)%, all significantly higher than [(2.1±0.3)mmol/L, (5.5±0.6)mmol/L, (3.1±0.4)mmol/L and (17.0±1.8)%, respectively, P<0.05] in patients with mild or [(4.0±0.4)mmol/L, (6.2±0.7)mmol/L, (3.4±0.4)mmol/L and (20.1±2.1)%, respectively P<0.05] in those with moderate liver steatosis, while serum high-density lipoprotein cholesterol level was (0.8±0.1)mmol/L, significantly lower than [(1.3±0.2)mmol/L, P<0.05] in mild or [(1.0±0.1)mmol/L, P<0.05] in those with moderate liver steatosis; ROC analysis showed that the AUC was 0.865, with Youden index of 0.568, sensitivity of 80.0% and specificity of 76.8%, when PDFF, with cut-off-value of 18.8%, was applied to predict moderate/severe liver steatosis in patients with NAFLD. Conclusion PDFF arose from MRI FACT has a certain diagnostic efficacy for assessing moderate to severe liver steatosis in NAFLD patients.

Key words: Non-alcoholic fatty liver disease, Liver steatosis, Magnetic resonance imaging, Multi-echo water-lipid separation technology, Proton density fat fraction , Diagnosis

袁伟文, 刘金武, 董婷, 何娴, 文华. 基于MRI水脂分离检测肝脏质子密度脂肪分数评估NAFLD患者脂肪变性程度应用研究^*[J]. 实用肝脏病杂志, 2026, 29(1): 61-64.

Yuan Weiwen, Liu Jinwu, Dong Ting, et al. MRI-proton density fat fraction in predicting liver steatosis in patients with non-alcoholic fatty liver disease[J]. Journal of Practical Hepatology, 2026, 29(1): 61-64.

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基于MRI水脂分离检测肝脏质子密度脂肪分数评估NAFLD患者脂肪变性程度应用研究^*

MRI-proton density fat fraction in predicting liver steatosis in patients with non-alcoholic fatty liver disease

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