首页|MRI ideal-iq技术联合血清学指标在乙型肝炎患者肝纤维化分期中的应用

MRI ideal-iq技术联合血清学指标在乙型肝炎患者肝纤维化分期中的应用

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目的 探讨磁共振最小二乘法估计和不对称回波迭代分解水和脂肪的脂肪成像(MRI ideal-iq)技术联合血清学指标在乙型肝炎患者肝纤维化分期中的应用价值.方法 选取2021年1月至2023年1月淮南市第一人民医院收治的乙型肝炎患者100例,其中S0~S1期41例、S2期28例、S3期17例和S4期14例.比较4组患者IDEAL-IQ参数、血清学指标[透明质酸(HA)、Ⅳ型胶原(CIV)、层联蛋白(LN)]和肝功能[丙氨酸氨基转移酶(ALT)、天门氨酸氨基转移酶(AST)、白蛋白].ROC分析ideal-iq参数联合血清学指标预测早期肝硬化(S4期)的价值;相关性分析ideal-iq参数、血清学指标与肝纤维化的关系.结果 S0~S1 期组 FF、R2*值、HA、CIV 为(1.51±0.33)%、(54.58±8.15)Hz、(139.05± 60.57)μg/L、(88.24±24.78)ng/mL,S2 期组为(2.01±0.42)%、(69.07±7.44)Hz、(337.56±113.24)μg/L、(106.04± 30.21)ng/mL,S3 期组为(3.07±0.46)%、(94.55±10.53)Hz、(416.08±124.51)μg/L、(134.07±38.76)ng/mL,S4 期组为(4.32±0.53)%、(111.14±11.42)Hz、(583.76±150.54)μg/L、(190.06±42.83)ng/mL,4 组间比较差异有统计学意义(F=188.442、178.839、75.985、38.451,均P<0.05);4组间血清LN水平比较差异无统计学意义(P>0.05).ROC分析显示,FF、R2*值和血清HA、CIV水平预测早期肝硬化的曲线下面积分别为0.777、0.782、0.819、0.744,最佳截断值分别为 FF≥3.560%,R2*值≥102.950 Hz,HA≥517.210 μg/L,CIV ≥173.895 ng/mL,(均 P<0.05),联合预测早期肝硬化的曲线下面积为0.832,敏感度为0.786,均高于单项指标.S0~S1期组ALT、AST、白蛋白为(134.65±37.85)U/L、(74.22±20.57)U/L、(45.15±3.76)g/L,S2 期组为(192.08±47.52)U/L、(100.25±30.16)U/L、(43.45±3.01)g/L,S3期组为(214.12±55.63)U/L、(127.13±38.53)U/L、(40.35±5.24)g/L,S4 期组为(159.14±43.71)U/L、(101.54± 33.48)U/L、(37.42±3.65)g/L,4 组间比较差异有统计学意义(F=18.341、14.667、16.786,P<0.05).经相关性分析发现,FF、R2*值和血清HA、CIV水平与肝纤维化分期呈显著正相关(P<0.05);血清LN水平与肝纤维化分期无显著相关性(P>0.05).结论 FF、R2*值和血清HA、CIV水平在不同肝纤维化分期患者中均存在显著差异,且二者联合诊断早期肝硬化具有较高敏感度.
The application of MRI-ideal-iq technique combined with serological indexes in staging hepatic fibrosis in chronic hepatitis B patients
Objective To explore the application value of MRI least square estimation and asymmetric echo iterative lipography(MRI-ideal-iq)in combination with serological indicators in the staging of hepatic fibrosis(HF)in patients with chronic hepatitis B.Methods 100 patients with hepatitis B admitted to our hospital from January 2021 to January 2023 were selected in this study.According to the guidelines and liver biopsy results,100 patients were divided into stage S0-S1 group(n=41),stage S2 group(n=28),stage S3 group(n=17),and stage S4 group(n=14).The IDEAL-IQ parameters,serum indicators such as hyaluronic acid(HA),type Ⅳ collagen(CIV),laminin(LN),and liver function parameters including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and albumin were compared among the four groups of patients.The value of IDEAL-IQ parameters combined with serological indicators in predicting early liver cirrhosis(S4 stage)was evaluated by receiver operating characteristic curve(ROC)method.The relationship between IDEAL-IQ parameters,serological indicators,and HF were evaluated by Correlation analysis.Results The FF,R2*value,HA,and CIV levels were(1.51±0.33)%,(54.58±8.15)Hz,(139.05±60.57)μg/L,and(88.24±24.78)ng/mL in S0 to S1 group,respectively;(2.01±0.42)%,(69.07±7.44)Hz,(337.56±113.24)µg/L,and(106.04± 30.21)ng/mL in S2 group;(3.07±0.46)%,(94.55±10.53)Hz,(416.08±124.51)μg/L,and(134.07±38.76)ng/ml in S3 group;(4.32±0.53)%,(111.14±11.42)Hz,(583.76±150.54)μg/L,and(190.06±42.83)ng/mL in S4 group.There was a statistically significant difference between the four groups(F=188.442,178.839,75.985,38.451,P<0.05);There was no significant difference in serum levels of LN among the four groups(P>0.05).By ROC analysis it was shown that the areas under the curves of FF,R2*value,serum HA and CIV levels for predicting early cirrhosis were 0.777,0.782,0.819,and 0.744,respectively,with the optimal cutoff values of FF≥3.560%,R2*value≥102.950 Hz,HA≥517.210 μg/L,and CIV≥173.895 ng/mL,all P<0.05.The area under the curve of a combined prediction for early liver cirrhosis was 0.832,with a sensitivity of 0.786,both were higher than those of the single indicators.The levels of ALT,AST,and albumin were(134.65± 37.85)U/L,(74.22±20.57)U/L,and(45.15±3.76)g/L in S0-S1 group,respectively,(192.08±47.52)U/L,(100.25± 30.16)U/L,and(43.45±3.01)g/L in S2 group,(214.12±55.63)U/L,(127.13±38.53)U/L,and(40.35±5.24)g/L in S3 group,(159.14±43.71]U/L,(101.54±33.48)U/L,(37.42±3.65)g/L in S4 group,The differences between the four groups were statistically significant(F=18.341,14.667,16.786,P<0.05).By correlation analysis,it was found that FF,R2*values,serum HA and CIV levels were positively correlated with HF staging(P<0.05);There was no significant correlation between serum LN levels and HF stagings(P>0.05).Conclusion The FF,R2*values,as well as serum HA and CIV levels show significant differences in patients with different HF stages,which may reflect the degree of HF.Moreover,the combination of them has high sensitivity in diagnosing early cirrhosis.

Magnetic resonanceLeast squares estimation and asymmetric echo iterative decomposition for fat imaging of water and fatHepatitis BStaging of liver fibrosisSerological indicators

刘静、郭飞、吴露露、李贺

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233030 安徽蚌埠医学院

淮南市第一人民医院磁共振室

蚌埠医学院第一附属医院放射科

蚌埠市第二人民医院CT室

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磁共振 最小二乘法估计和不对称回波迭代分解水和脂肪的脂肪成像 乙肝 肝纤维化分期 血清学指标

淮南市科技计划项目

2018A3613

2024

肝脏
上海市医学会

肝脏

CSTPCD
影响因子:0.71
ISSN:1008-1704
年,卷(期):2024.29(4)
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