1.重庆市中医院放射科,重庆 400021
2.陆军军医大学第一附属医院放射科,重庆 400038
3.陆军军医大学第一附属医院感染科,重庆 400038
Received:11 March 2024,
Published:25 March 2025
移动端阅览
胡勤勤,杨华,陈家飞等.磁共振多回波Dixon技术脂肪含量测量联合血清学指标对早期肝纤维化的诊断价值[J].局解手术学杂志,2025,34(03):245-249.
HU Qin-qin,YANG Hua,CHEN Jia-fei,et al.Diagnostic value of fat content measurement by magnetic resonance multi-echo Dixon technique combined with serological indicators for early liver fibrosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(03):245-249.
胡勤勤,杨华,陈家飞等.磁共振多回波Dixon技术脂肪含量测量联合血清学指标对早期肝纤维化的诊断价值[J].局解手术学杂志,2025,34(03):245-249. DOI: 10.11659/jjssx.03E024058.
HU Qin-qin,YANG Hua,CHEN Jia-fei,et al.Diagnostic value of fat content measurement by magnetic resonance multi-echo Dixon technique combined with serological indicators for early liver fibrosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(03):245-249. DOI: 10.11659/jjssx.03E024058.
目的
2
分析基于磁共振多回波Dixon(ME-Dixon)技术的脂肪含量测量联合血清学指标对早期肝纤维化的诊断价值。
方法
2
纳入陆军军医大学第一附属医院2019年8月至2021年10月行肝组织穿刺活检的早期肝纤维化患者78例,根据病理结果将早期肝纤维化患者分为S0组(
n
=21
)、S1组(
n
=32)、S2组(
n
=25)。同时收集患者完整影像检查结果(包含ME-Dixon序列)和实验室检查结果[包括透明质酸酶(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ-谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)
]
,并通过ME-Dixon技术测量肝脂肪分数(HFF)。采用单因素方差分析3组间HFF及血清学指标的差异,然后选取单因素分析中有统计学差异的因素绘制受试者工作特征(
ROC
)曲线,计算曲线下面积(
AUC
),评估其诊断肝纤维化及早期肝纤维化程度的价值。
结果
2
S0、S1、S2组间PCⅢ、LN、AST、ALT比较差异无统计学意义(
P
>
0.05),HFF、HA、CⅣ、GGT、ALP比较差异有统计学意义(
P
<
0.05),而S2组HA、CⅣ、GGT、ALP明显高于S0、S1组(
P
<
0.05)。
ROC
曲线分析显示,上述指标在判断肝纤维化和早期肝纤维化程度中按
AUC
大小依次为HFF+GGT(0.72)
>
HFF(0.68)
>
GGT(0.61)
>
CⅣ(0.54)
>
ALP(0.53)
>
HA(0.48)和HA+CⅣ(0.71)
>
CⅣ(0.68)
>
HA(0.66)
>
GGT(0.61)
>
ALP(0.59)
>
HFF(0.46)。
结论
2
基于磁共振ME-Dixon技术的脂肪含量测量联合血清学指标对早期肝纤维化诊断具有重要参考价值,在临床诊疗中有一定指导作用。
Objective
2
To analyze the diagnostic value of fat content measurement based on magnetic resonance multi-echo Dixon (ME-Dixon) technique combined with serological indicators for early liver fibrosis.
Methods
2
A total of 78 patients with early liver fibrosis who underwent liver biopsy at the First Affiliated Hospital of Army Medical University from August 2019 to October 2021 were included. According to the pathological results, the patients with early liver fibrosis were divided into the S0 group (
n
=21), the S1 group (
n
=32), and the S2 group (
n
=25). Meanwhile, the complete imaging examination results (including ME-Dixon sequence) and laboratory examination results [including hyaluronic acid (HA),procollagen Ⅲ (PCⅢ), collagen Ⅳ(CⅣ),laminin (LN),aspartate transaminase (AST),alanine aminotransferase(ALT), gamma-glutamyl transferase (GGT),alkaline phosphatase (ALP)] were collected. And the hepatic fat fraction (HFF) was measured by ME-Dixon technique.
One
-
way ANOVA
was used to analyze the differences in HFF and serological indicators among the three groups, and then factors with statistical differences in the univariate analysis were selected to draw
receiver operating characteristic
(
ROC
) curve, and the
area under the curve
(
AUC
) was calculated to evaluate their value in the diagnosis of liver fibrosis and the degree of early liver fibrosis.
Results
2
There was no statistically significant difference in the PCⅢ, LN, AST, or ALT among the S0, S1, and S2 groups (
P
>
0.05), while there were statistically significant differences in the HFF, HA, CⅣ, GGT, and ALP (
P
<
0.05), and the levels of HA, CⅣ, GGT, and ALP in the S2 group were significantly higher than those in the S0 and S1 groups (
P
<
0.05).
ROC
curve analysis showed that the above indicators for diagnosing liver fibrosis and the degree of early liver fibrosis based on
AUC
values were in the following order: HFF+GGT (0.72)
>
HFF (0.68)
>
GGT (0.61)
>
CⅣ (0.54)
>
ALP (0.53)
>
HA (0.48) and HA+CⅣ (0.71)
>
CⅣ (0.68)
>
HA (0.66)
>
GGT (0.61)
>
ALP (0.59)
>
HFF (0.46).
Conclusion
2
The fat content measurement based on magnetic resonance ME-Dixon technique combined with serological indicators has significant reference value for the diagnosis of early liver fibrosis, and it plays a certain guiding role in clinical diagnosis and treatment.
Tapper EB , Lok AS . Use of liver imaging and biopsy in clinical practice [J]. N Engl J Med , 2017 , 377 ( 8 ): 756 - 768 . doi: 10.1056/NEJMra1 610570 http://dx.doi.org/10.1056/NEJMra1610570 .
壮健 , 朱韦文 , 张超 . 基于LASSO回归的慢性乙型肝炎肝纤维化无创诊断模型的构建及验证 [J]. 临床肝胆病杂志 , 2022 , 38 ( 8 ): 1790 - 1795 . doi: 10.3969/j.issn.1001-5256.2022.08.014 http://dx.doi.org/10.3969/j.issn.1001-5256.2022.08.014 .
Yan S , Huda N , Khambu B , et al . Relevance of autophagy to fatty liver diseases and potential therapeutic applications [J]. Amino Acids , 2017 , 49 : 1965 - 1979 . doi: 10.1007/s00726-017-2429-y http://dx.doi.org/10.1007/s00726-017-2429-y .
蔡齐芳 , 金科 , 向永华 , 等 . 六回波Dixon序列对非酒精性脂肪性肝病儿童肝脏和胰腺脂肪含量的定量研究 [J]. 放射学实践 , 2023 , 38 ( 4 ): 497 - 502 . doi: 10.13609/j.cnki.1000-0313.2023.04.021 http://dx.doi.org/10.13609/j.cnki.1000-0313.2023.04.021 .
杨莹 , 李洁 , 周静 , 等 . 多回波Dixon技术在非酒精性脂肪肝中脂肪定量及铁沉积的应用进展 [J]. 国际医学放射学杂志 , 2020 , 43 ( 2 ): 206 - 210 . doi: 10.19300/j.2020.Z17726 http://dx.doi.org/10.19300/j.2020.Z17726 .
Hervouet E , Pecina P , Demont J , et al . Inhibition of cytochrome c oxidase subunit 4 precursor processing by the hypoxia mimic cobalt chloride [J]. Biochem Biophys Res Commun , 2006 , 344 ( 4 ): 1086 - 1093 . doi: 10.1016/j.bbrc.2006.04.014 http://dx.doi.org/10.1016/j.bbrc.2006.04.014 .
Dhar D , Baglieri J , Kisseleva T , et al . Mechanisms of liver fibrosis and its role in liver cancer [J]. Exp Biol Med (Maywood) , 2020 , 245 ( 2 ): 96 - 108 . doi: 10.1177/1535370219898141 http://dx.doi.org/10.1177/1535370219898141 .
张腊英 , 何安玲 , 陈明锴 . 基于生物信息学分析肝纤维化的关键基因及相关通路研究 [J]. 局解手术学杂志 , 2024 , 33 ( 2 ): 106 - 111 . doi: 10.11659/jjssx.03E023022 http://dx.doi.org/10.11659/jjssx.03E023022 .
Li T , Che-Nordin N , Wáng YXJ , et al . Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis [J]. Quant Imaging Med Surg , 2019 , 9 ( 3 ): 371 - 385 . doi: 10.21037/qims.2019. 02.11 http://dx.doi.org/10.21037/qims.2019.02.11 .
中华医学会肝病学分会 , 中华医学会消化病学分会 , 中华医学会感染病学分会 . 肝纤维化诊断及治疗共识(2019年) [J]. 中华肝脏病杂志 , 2019 , 27 ( 9 ): 657 - 667 . doi: 10.3760/cma.j.issn.1007-3418.2019.09.001 http://dx.doi.org/10.3760/cma.j.issn.1007-3418.2019.09.001 .
赵俊苹 , 李红 , 刘昊沅 , 等 . 磁共振弹性成像在肝纤维化定量诊断与分期中的研究进展 [J]. 磁共振成像 , 2021 , 12 ( 12 ): 112 - 114 . doi: 10.12015/issn.1674-8034.2021.12.027 http://dx.doi.org/10.12015/issn.1674-8034.2021.12.027 .
Dixon WT . Simple proton spectroscopic imaging [J]. Radiology , 1984 , 153 : 189 - 194 . doi: 10.1148/radiology.153.1.6089263 http://dx.doi.org/10.1148/radiology.153.1.6089263 .
应洁 , 刘丹 , 杨全 , 等 . 3.0T MRI双回波水脂分离Dixon技术在非酒精性脂肪肝患者肝脏脂肪含量定量测定中的应用 [J]. 磁共振成像 , 2020 , 11 ( 7 ): 577 - 580 . doi: 10.12015/issn.1674-8034.2020.07.020 http://dx.doi.org/10.12015/issn.1674-8034.2020.07.020 .
赵凡玉 , 周婷 , 黄江 , 等 . MR定量技术评估伴纤维化非酒精性脂肪性肝病的研究 [J]. 中国医学影像学杂志 , 2022 , 30 ( 2 ): 100 - 105 . doi: 10.3969/j.issn.1005-5185.2022.02.002 http://dx.doi.org/10.3969/j.issn.1005-5185.2022.02.002 .
张敏 , 王敏 , 贾守强 , 等 . 3D-DIXON定量评价肝内脂肪含量的稳定性研究 [J]. 医学影像学杂志 , 2018 , 28 ( 2 ): 251 - 253 .
周围 , 陈晓巧 , 周园园 , 等 . 磁共振Dixon技术全肝脂肪定量与肝穿刺活检结果比较 [J]. 医学影像学杂志 , 2018 , 28 ( 5 ): 775 - 780 .
金明丽 , 潘志华 , 舒健 , 等 . MRI定量评估不同肝纤维化分期大鼠肝脏脂肪含量 [J]. 实用放射学杂志 , 2021 , 37 ( 8 ): 1366 - 1369 . doi: 10.3969/j.issn.1002-1671.2021.08.034 http://dx.doi.org/10.3969/j.issn.1002-1671.2021.08.034 .
高琪 , 王付言 , 张晏境 , 等 . 氢质子MR波谱及多回波Dixon技术对非酒精性脂肪性肝病脂肪变定量诊断及分级的价值 [J]. 中华放射学杂志 , 2018 , 52 ( 9 ): 677 - 680 . doi: 10.3760/cma.j.issn. 1005-1201.2018.09.006 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2018.09.006 .
徐春玲 , 苗重昌 , 刘雨成 , 等 . 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 . doi: 10.3969/j.issn.1672-5069.2021.02.018 http://dx.doi.org/10.3969/j.issn.1672-5069.2021.02.018 .
黄江水 , 文建荣 , 宋国军 , 等 . MRI-PDFF降低对非酒精性脂肪性肝病患者肝纤维化预测研究 [J]. 影像研究与医学应用 , 2022 , 6 ( 23 ): 69 - 71 . doi: 10.3969/j.issn.2096-3807.2022.23.023 http://dx.doi.org/10.3969/j.issn.2096-3807.2022.23.023 .
Park CC , Nguyen P , Hernandez C , et al . Magnetic resonance elastography vs. transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease [J]. Gastroenterology , 2017 , 152 : 598 - 607 . doi: 10.1053/j.gastro.2016.10.026 http://dx.doi.org/10.1053/j.gastro.2016.10.026 .
汪苍 , 米瑞 , 叶海 , 等 . 磁共振T1mapping对大鼠肝纤维化分期的诊断价值及与血清标志物相关性分析 [J]. 临床放射学杂志 , 2019 , 38 ( 1 ): 189 - 193 . doi: 10.3969/j.issn.1005-4057.2021. 06.022 http://dx.doi.org/10.3969/j.issn.1005-4057.2021.06.022 .
Xu B , Zhou NM , Cao WT , et al . Evaluation of elastography combined with serological indexes for hepatic fibrosis in patients with chronic hepatitis B [J]. World J Gastroenterol , 2018 , 24 ( 37 ): 4272 - 4280 . doi: 10.3748/wjg.v24.i37.4272 http://dx.doi.org/10.3748/wjg.v24.i37.4272 .
黎琼岚 , 林立夫 , 李俐倩 , 等 . 乙型肝炎患者肝超声弹性值、肝脂肪含量与肝纤维化血清学指标的相关性 [J]. 广东医科大学学报 , 2021 , 39 ( 6 ): 750 - 752 . doi: 10.3969/j.issn.1005-4057.2021. 06.022 http://dx.doi.org/10.3969/j.issn.1005-4057.2021.06.022 .
张燕 , 肖湘 , 韩昌全 , 等 . 慢性乙肝患者HBV-DNA、肝功能指标与肝纤维化的关系 [J]. 临床消化病杂志 , 2021 , 33 ( 1 ): 36 - 40 . doi: 10.3870/lcxh.j.issn.1005-541X.2021.01.08 http://dx.doi.org/10.3870/lcxh.j.issn.1005-541X.2021.01.08 .
柳刚 , 贺军 , 申学舟 , 等 . 多模态超声弹性成像技术联合血清学指标对慢性乙型肝炎肝纤维化程度的诊断价值 [J]. 中西医结合肝病杂志 , 2021 , 31 ( 4 ): 335 - 337 . doi: 10.3969/j.issn.1005-0264.2021.04.012 http://dx.doi.org/10.3969/j.issn.1005-0264.2021.04.012 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
