基于磁共振质子密度脂肪分数的青岛沿海地区非酒精性脂肪性肝病定量分析  

Quantitative analysis of non-alcoholic fatty liver disease based on MRI proton density fat fraction in the coastal region of Qingdao

作　　者：朱月莉 徐志鹏[1] 郁万江[1] 辛永宁[2] 赵真真 刘守胜 吕奎荣[1] Zhu Yueli;Xu Zhipeng;Yu Wanjiang;Xin Yongning;Zhao Zhenzhen;Liu Shousheng;Lyu Kuirong(Department of Radiology,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266071,China;Department of Infectious Diseases,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266071,China;Clinical Research Center,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学附属青岛市市立医院放射科,266071 [2]青岛大学附属青岛市市立医院感染性疾病科,266071 [3]青岛大学附属青岛市市立医院临床研究中心,266071

出　　处：《中华肝脏病杂志》2021年第11期1077-1082,共6页Chinese Journal of Hepatology

摘　　要：目的探讨不同肝段磁共振质子密度脂肪分数(MRI-PDFF)值评估非酒精性脂肪性肝病(NAFLD)的临床应用价值。方法纳入2019年3月至2020年2月志愿者178名, 均采用CSE3.0T MRI扫描并测量9个肝段PDFF值, 取平均值代表肝脏平均脂肪含量;将肝脏各肝段及组合肝段的PDFF值与平均值比较, 观察各肝段或肝段组合脂肪含量的代表性。受试者操作特征曲线用于分析各肝段诊断效能, 用约登指数计算截断值。计量资料组间比较采用配对样本t检验或非参数方法Kruskal-Wallis检验。结果 178名志愿者经MRI-PDFF测量, 肝脏平均脂肪含量为0.89%~42.61%, 71.35%(127/178)的志愿者PDFF > 5%。SⅢ、SⅣb、S V、SⅧ肝段PDFF值与平均值相比, 无明显差异(P值均> 0.05)。SⅠ、SⅡ、SⅣa肝段PDFF值低于平均值, 而SⅥ、SⅦ肝段PDFF值高于平均值(P值均< 0.05)。9个肝段MRI-PDFF值诊断肝脏脂肪变性的灵敏度为85.8%~94.5%, 特异度均高于96.0%, 其中S V(94.5%)段灵敏度最高, 对应的最佳诊断界值为5.13%。相较于单一肝段和组合肝段, 肝脏SⅡ、S V、SⅥ组合肝段的PDFF值诊断脂肪肝的效能最高, 灵敏度为96.9%, 特异度为100%, 对应的最佳诊断界值为5.17%。结论相对于单一肝段和其他组合肝段, 肝脏SⅡ、S V、SⅥ组合肝段的MRI-PDFF值诊断NAFLD灵敏度和特异度均较高, 可作为应用MRI测定肝脏脂肪含量的首选区域。Objective To explore the clinical application value of MRI-PDFF on different liver segments for the evaluation of non-alcoholic fatty liver disease(NAFLD).Methods 178 volunteers from March 2019 to February 2020 were included.PDFF values of all nine segments of the liver were measured using CSE3.0T MRI scan.The obtained average value was used to represent the average liver fat content.PDFF values of each or combined liver segment were equally compared with the average value to observe the representativeness of fat content.Receiver operating characteristic curve was used to analyze the diagnostic performance of each liver segment,and the Youden index was used to calculate the cutoff value.Paired-sample t-test or non-parametric Kruskal-Wallis test were used to compare measurement data among groups.Results 178 volunteers average liver fat content ranged from 0.89%to 42.61%with MRI-PDFF,and 71.35%(127/178)of the volunteers had PDFF>5%.There was no significant difference between SⅢ,SⅣb,SV,and SⅧliver segments when compared with the average value(P>0.05).PDFF values of SⅠ,SⅡ,and SⅣa liver segments were all lower than the average value,while the PDFF values of SⅥand SⅦliver segments were all higher than the average value(P<0.05).MRI-PDFF sensitivity value for diagnosing liver steatosis of nine liver segments was 85.8%~94.5%,and the specificity was higher than 96.0%.Among them,the SⅤliver segment had the highest sensitivity(94.5%),and the corresponding optimal diagnostic threshold value was 5.13%.Compared with single and combined liver segment,the PDFF value of SⅡ,SⅤ,SⅥcombined liver segment had the highest diagnostic performance for fatty liver,with the sensitivity and specificity of 96.9%,and 100%,respectively,and the corresponding optimal diagnostic threshold value was 5.17%.Conclusion Compared with single and other combined liver segments,MRI-PDFF values of SII,SV,and SVI combined liver segments have higher sensitivity and specificity for the diagnosis of NAFLD,and it can be used as the first c

关 键 词：非酒精性脂肪性肝病 磁共振成像 质子密度脂肪分数 化学位移 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]