MRI肝脏T1弛豫时间预测乙型肝炎肝硬化患者门静脉高压应用研究*

doi:10.3969/j.issn.1672-5069.2026.01.023

摘要/Abstract

摘要： 目的应用磁共振成像(MRI)肝脏T1弛豫时间评估乙型肝炎肝硬化患者并发门静脉高压,分析其应用价值。方法 2019年1月～2024年12月我院收治的115例乙型肝炎肝硬化患者均接受MRI检查,测量肝脏T1弛豫时间。经颈静脉穿刺测量、计算肝静脉压力梯度(HVPG)。应用多因素Logistic回归分析影响乙型肝炎肝硬化患者发生门静脉高压的因素,绘制受试者工作特征(ROC)曲线评估T1弛豫时间预测乙型肝炎肝硬化患者并发门静脉高压的效能。结果在115例乙型肝炎肝硬化患者中,发现门静脉高压74例(64.4%);门静脉高压组Child-Pugh评分、凝血酶原时间(PT)、肝脏硬度检测(LSM)、增强肝纤维化评分(ELF)和MRI肝脏T1弛豫时间分别为(10.7±2.7)分、(13.1±2.3)s、(18.0±3.2)kPa、(15.8±1.8)分和(880.3±96.7)ms,均显著大于或高于非门静脉高压组【分别为(7.5±1.9)分、(11.6±1.8)s、(14.8±1.1)kPa、(12.7±1.4)分和(779.4±80.3)ms,P＜0.05】;多因素Logistic回归分析显示PT、LSM、ELF和T1弛豫时间均为乙型肝炎肝硬化患者发生门静脉高压的独立影响因素(P＜0.05);以MRI肝脏T1弛豫时间为860.0 ms为截断点,ROC曲线分析显示诊断肝硬化患者门静脉高压的AUC为0.788(95%CI:0.702~0.858),其敏感度和特异度分别为67.6%和85.4%(Z=6.848,P＜0.001)。结论应用MRI肝脏T1弛豫时间评估乙型肝炎肝硬化患者门静脉高压有一定的新意和临床价值,值得深入研究。

关键词: 肝硬化, 门静脉高压, 磁共振成像, T1弛豫时间, 诊断

Abstract: Objective The aim of this study was to investigate application of T1 relaxation time of liver magnetic resonance imaging (MRI) in detecting portal hypertension (PH) in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 115 patients with hepatitis B-induced LC were admitted to our hospital between January 2019 and December 2024, all patients underwent MRI scan for detection of T1 relaxation time, and transjugular puncture for measurement and calculation of hepatic venous pressure gradient (HVPG). Multivariate Logistic regression analysis was conducted to identify influencing factors of portal hypertension in patients with hepatitis B cirrhosis and the receiver operating characteristic (ROC) curve was drawn to analyze predicting efficacy of PH by T1 relaxation time. Results Of the 115 patients with LC, PH was found in 74 cases (64.4%); Child-Pugh score, prothrombin time (PT), liver stiffness measurement (LSM), enhanced liver fibrosis (ELF) score and MRI T1 relaxation time of liver in patients with PH were (10.7±2.7), (13.1±2.3)s, (18.0±3.2)kPa, (15.8±1.8) and (880.3±96.7)ms, all significantly greater or higher than [(7.5±1.9), (11.6±1.8)s, (14.8±1.1)kPa, (12.7±1.4) and (779.4±80.3)ms, respectively, P＜0.05] in cirrhotics without PH; multivariate Logistic regression analysis showed that PT, LSM, ELF and T1 relaxation time were all the independent impacting factors for PH in patients with LC(P＜0.05); ROC analysis demonstrated that the AUC was 0.788(95%CI:0.702-0.858), with sensitivity and specificity of 67.6% and 85.4%(Z=6.848, P＜0.001), when MRI T1 relaxation time equal to 860.0 ms was set as the cut-off-value in predicting PH in patients with LC. Conclusion Measurement of MRI T1 relaxation time of liver might help clinicians predict PH in patients with LC, which warrants further clinical investigation.

Key words: Liver cirrhosis, Portal hypertension, Magnetic resonance imaging, T1 relaxation time, Diagnosis

姚柳, 刘琦, 姜亦伦, 徐剑. MRI肝脏T1弛豫时间预测乙型肝炎肝硬化患者门静脉高压应用研究^*[J]. 实用肝脏病杂志, 2026, 29(1): 89-92.

Yao Liu, Liu Qi, Jiang Yilun, et al. T1 relaxation time of liver MRI in detecting portal hypertension in patients with hepatitis B-induced liver cirrhosis[J]. Journal of Practical Hepatology, 2026, 29(1): 89-92.

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MRI肝脏T1弛豫时间预测乙型肝炎肝硬化患者门静脉高压应用研究^*

T1 relaxation time of liver MRI in detecting portal hypertension in patients with hepatitis B-induced liver cirrhosis

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