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首页> 外文期刊>Radiology >MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: Does histologic necroinflammation influence the measurement of hepatic stiffness?
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MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: Does histologic necroinflammation influence the measurement of hepatic stiffness?

机译：MR弹性成像技术在慢性乙型肝炎感染患者肝纤维化评估中的应用：组织学坏死性炎症是否会影响肝硬度的测量？

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Purpose: To determine the diagnostic performance of magnetic resonance (MR) elastography for the staging of hepatic fibrosis and to evaluate the influence of necroinflammation on hepatic stiffness in patients with chronic hepatitis B virus (HBV) infection by using histopathologic findings as the reference standard.Materials and Methods: One hundred thirteen consecutive patients with chronic HBV infection were recruited prospectively in this institutional review board-approved study after providing written informed consent between March 2012 and October 2013. The stiffness measurements were obtained by using two-dimensional gradient-echo MR elastography with a 3.0-T MR system. The METAVIR scoring system was used for the assessment of fibrosis ("F" stage) and necroinflammation ("A" grade). The predictive ability of MR elastography was evaluated by using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). Multiple linear regression analyses were conducted to determine the relationship between hepatic stiffness and the variables that showed a significant association in the univariate analysis or those that were of interest for comparison with earlier work (histologic scores, sex, age, aspartate aminotransferase level, and aspartate aminotransferase/alanine aminotransferase ratio).Results: MR elastography showed excellent performance for characterization of ≥F1, ≥F2, ≥F3, and F4 findings, with AUC values of 0.961, 0.986, 1.000, and 0.998, respectively. It showed a moderate capability for evaluation of necroinflammatory activity of ≥A1, ≥A2, and A3 (AUC = 0.806, 0.834, and 0.906, respectively). Multiple linear regression analysis showed that fibrosis, necroinflammation, and sex were independently associated with hepatic stiffness (b = 0.799, 0.277, and 0.070, respectively; P < .05). For pairwise comparisons, log-transformed hepatic stiffness showed no difference between (a) groups F0/A2-3 and F1/A0-1 and (b) groups F1/ A2-3 and F2/A0-1 (P > .99 and P = .486, respectively).Conclusion: MR elastography demonstrated excellent performance for distinguishing the stages of hepatic fibrosis in patients with chronic HBV infection. For hepatic tissue with ≥F2 fibrosis, necroinflammation can account for a substantial fraction of the increase in hepatic stiffness.
机译：目的：以组织病理学结果为参考标准，确定磁共振（MR）弹性成像在肝纤维化分期中的诊断性能，并评估坏死性炎症对慢性乙型肝炎病毒（HBV）感染患者肝硬度的影响。资料和方法：在2012年3月至2013年10月之间提供书面知情同意书后，在该机构审查委员会批准的研究中前瞻性招募了113例慢性HBV感染患者。采用二维梯度回波MR来测量僵硬度弹性成像，带有3.0-T MR系统。 METAVIR评分系统用于评估纤维化（“ F”级）和坏死性炎症（“ A”级）。 MR弹性成像的预测能力通过使用接收器工作特征（ROC）曲线和ROC曲线下面积（AUC）进行评估。进行了多个线性回归分析，以确定肝硬度与变量之间的关系，这些变量在单变量分析中显示出显着的相关性，或者与早期工作比较时感兴趣的变量（组织学评分，性别，年龄，天冬氨酸转氨酶水平和天冬氨酸）结果：MR弹性成像显示出对≥F1，≥F2，≥F3和F4发现的特征表现出色，AUC值分别为0.961、0.986、1.000和0.998。它显示出中等的评估其≥A1，≥A2和A3的炎症反应能力（AUC分别为0.806、0.834和0.906）。多元线性回归分析显示，纤维化，坏死性炎症和性别与肝硬度无关（b分别为0.799、0.277和0.070; P <.05）。对于成对比较，对数转换后的肝硬度显示（a）F0 / A2-3组和F1 / A0-1组与（b）F1 / A2-3组和F2 / A0-1组之间无差异（P> .99和结论：MR弹性成像在区分慢性HBV感染患者的肝纤维化分期方面表现出出色的表现。对于≥F2纤维化的肝组织，坏死性炎症可占肝硬度增加的很大一部分。

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