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。
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.