Gd-EOB-DTPA增强T1ρ成像定量评价非酒精性脂肪肝炎的实验研究  

The experimental study of Gd-EOB-DTPA enhanced T1ρ imaging in quantitative evaluation of nonalcoholic steatohepatitis

作　　者：陈发祥[1] 谢元亮[1] 张树桐 王翔[1] 李惠 CHEN Faxiang;XIE Yuanliang;ZHANG Shutong;WANG Xiang;LI Hui(Department of Radiology,Wuhan Central Hospital Affiliated to Tongji Medical College ofHuazhong University of Science and Techology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院影像科,湖北武汉430014

出　　处：《实用放射学杂志》2019年第3期473-477,共5页Journal of Practical Radiology

基　　金：湖北省卫生和计划生育委员会临床科研项目(WJ2017F019)。

摘　　要：目的探讨钆塞酸二钠(Gd-EOB-DTPA)增强T1ρ对非酒精性脂肪肝炎(NASH)严重性和炎症分级的诊断价值。方法 26只成年大白兔以高脂-高胆固醇饲料喂养时长分别为0、4、8周和12周建立NASH模型;比较不同非酒精性脂肪性肝病活动度积分(NAS)和炎症分级(G0、G1、G2、G3)间T1ρ、肝胆期T1ρ(HBP)、T1ρ变化值(Δ%)差异;T1ρ和T1ρ(HBP)与NAS评分和炎症分级相关性分析采用Spearman相关性检验;采用ROC曲线分析评价T1ρ、T1ρ(HBP)对NASH和进展期炎症的诊断价值;多元线性回归方程分析T1ρ(HBP)的独立影响因子。结果 T1ρ和T1ρ(HBP)值与NAS评分和炎症评分均呈正相关;NASH组的T1ρ(HBP)值与对照组、非酒精性脂肪肝(NAFL)均存在显著性差异(P<0.05),G3的T1ρ(HBP)值与G2、G1和G0存在统计学差异(P<0.05);T1ρ、T1ρ(HBP)诊断NASH的AUC分别为0.849、0.949;诊断G2-3炎症的AUC分别为0.925、0.922;纤维化和炎症是T1ρ(HBP)主要独立影响因子。结论 Gd-EOB-DTPA增强T1ρ成像能反映NASH的严重性和炎症程度,T1ρ(HBP)在评价NASH活动性积分和炎症分级的诊断价值优于T1ρ,是更好的无创性影像标记物。Objective To assess the value of Gd-EOB-DTPA enhanced T1ρ imaging in evaluating the severity and inflammation grade in nonalcoholic steatohepatitis ( NASH ) rabbits model.Methods NASH models were established in 26 adult rabbits by feeding with the high-fat, high-cholesterol diet in a varied durations (0,4,8,12 weeks).T1ρ,T1ρ in the hepatobiliary phase ( HBP) and change of T1ρ(△%) were compared among the different groups which were determined by different non-alcoholic fatty liver disease activity score ( NAS) and inflammation grades.Spearman correlation analysis was used to assess the correlations of T1ρ,T1ρ( HBP) with NAS scores and inflammation grades.ROC curve was performed to evaluate the diagnostic value of T1ρ,T1ρ( HBP) in predicting NASH and advanced inflammation.Results T1ρ and T1ρ( HBP) were positively associated with NAS and inflammation scores.The differences of T1ρ( HBP) among NASH,nonalcoholic fatty liver ( XAFL) and normal liver were statistically significani (P<0.05). T1ρ( HBP) was significantly different in the rabbits with grade 3 inflammation from in the rabbits with grade 0.grade 1 and grade 2 inflammation (P<0.05). AUCs of T1ρ and T1ρ( HBP) for differentiating NASH were 0.849 and 0.949 , respectively. AUC of T1ρ and T1ρ-HBP for diagnosing grade 2 and grade 3 inflammation were 0.925 and 0.922, respectively. Fibrosis and inflammation were the main independent factors affecting T1(HBP).Conclusion Gd-EOB- DTPA enhanced T1ρ imaging can reflect the severity of NASH and degree of inflammation. T1ρ( HBP) might be a more superior noninvasive imaging biomarkcr than non enhanced T1ρ for assessment of NASH activity and inflammation grading.

关 键 词：非酒精性脂肪肝炎 磁共振成像 定量评价 

分 类 号：R575.5[医药卫生—消化系统] R445.2[医药卫生—内科学]