上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (11): 1470-.doi: 10.3969/j.issn.1674-8115.2017.11.004

• 论著（基础研究） • 上一篇    下一篇

三维自旋晶格弛豫磁共振成像诊断肝纤维化分期的实验研究#br#

李若坤 1，强呼明 2，严福华 1，任新平 3，王韬 1，陈伟波 4   

  1. 1. 上海交通大学  医学院附属瑞金医院放射科 , 上海 200025；2. 上海交通大学  医学院附属瑞金医院苏州分院（苏州市吴江区中西医结合医院） 放射科，苏州 215101；3. 上海交通大学  医学院附属瑞金医院超声科，上海 200025；4. 飞利浦医疗中国影像研究学院，上海 200070
  • 出版日期:2017-11-28 发布日期:2018-01-10
  • 通讯作者: 严福华，电子信箱：yfh11655@rjh.com.cn
  • 作者简介:李若坤（1981—），男，副主任医师，博士；电子信箱：lrk12113@rjh.com.cn
  • 基金资助:
    国家自然科学基金（81371520）

T1ρ magnetic resonance imaging for liver fibrosis detection and staging

LI Ruo-kun1, QIANG Hu-ming2, YAN Fu-hua1, REN Xin-ping3, WANG Tao1, CHEN Wei-bo4   

  1. 1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. Department of Radiology, Hospital of Integrated Traditional Chinese Medicine and Western Medicine of Wujiang District, Suzhou 215101, China; 3. Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 4. Philips Healthcare, Shanghai 200070, China
  • Online:2017-11-28 Published:2018-01-10
  • Supported by:
    National Natural Science Foundation of China, 81371520

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摘要： 目的 · 探讨三维自旋晶格弛豫（T1ρ）磁共振成像诊断肝纤维化分期的价值，并与超声弹性成像进行比较。方法 · 采用 CCl4 腹腔注射法诱导建立兔肝纤维化模型，分为实验组（n=29）和正常对照组（n=6）。在造模后第 2、4、6、8、10、12 周进行 T1ρ 成像 和二维剪切波弹性成像（SWE），测量肝脏 T1ρ 值和肝硬度（LS）值。根据 METAVIR 系统进行肝纤维化分期。Spearman 等级相关分 析明确肝纤维化分期与T1ρ 值和LS 值的相关性，采用受试者工作特性（ROC）曲线明确T1ρ 与 SWE 对各期肝纤维化的诊断效能。 结果 · T1ρ 值与纤维化分期呈中等程度正相关（r=0.566，P=0.000）， LS 值与纤维化分期呈显著正相关（r=0.726，P=0.003）。 T1ρ 成 像和SWE 诊断≥F1、≥F2、≥F3、F4 期肝纤维化的ROC 曲线下面积比较差异均无统计学差异（≥F1，0.856 vs 0.861，P=0.940； ≥ F2，0.849 vs 0.906，P=0.414；≥ F3，0.799 vs 0.870，P=0.422；F4，0.692 vs 0.846，P=0.137）。 结论 · T1ρ 成像可以准确诊断各期 肝纤维化，其诊断效能与二维 SWE 相仿。

关键词: 肝纤维化, 自旋晶格弛豫, 弹性成像, 超声, 磁共振成像

Abstract:

Objective · To investigate the value of three-dimensional spin-lattice relaxation (T1ρ) magnetic resonance imaging (MRI) for liver fibrosis detection and staging and compare with two-dimentional real-time shear wave elastography (SWE).  Methods · Twenty-nine rabbit models of CCl4-induced liver fibrosis were established and six untreated rabbits served as controls. T1ρ MRI and two-dimentional real-time SWE examinations were performed at 2, 4, 6, 8, 10 and 12 weeks, respectively. T1ρ values and liver stiffness (LS) values were measured. Fibrosis was staged according to the METAVIR scoring system. Correlation test was performed among T1ρ values, LS values and fibrosis staging. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of T1ρ and SWE in detection of fibrosis.  Results · There was a moderate positive correlation between fibrosis staging and T1ρ values (r=0.566, P=0.000), and a significantly positive correlation between fibrosis staging and LS values (r=0.726, P=0.003). Areas under ROC were 0.861 for SWE and 0.856 for T1ρ (P=0.940), 0.906 for SWE and 0.849 for T1ρ (P=0.414), 0.870 for SWE and 0.799 for T1ρ (P=0.422), and 0.846 for SWE and 0.692 for T1ρ (P=0.137), when diagnosing liver fibrosis with ≥ F1, ≥ F2, ≥ F3 and F4 stage, respectively. 
 Conclusion · T1ρ imaging has potential for liver fibrosis detection and staging with good diagnostic capability similar to that of SWE.

Key words:  liver fibrosis, spin-lattice relaxation, elastography, ultrasonography, magnetic resonance imaging