Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acidenhanced magnetic resonance imaging for evaluating fibrosis regression in chronic hepatitis C patients after direct-acting antiviral  

作　　者：Xiao-He Li Rui Huang Ming Yang Jian Wang Ying-Hui Gao Qian Jin Dan-Li Ma Lai Wei Hui-Ying Rao 

机构地区：[1]Peking University Hepatology Institute,Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases,Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis,Peking University People’s Hospital,Beijing 100044,China [2]Hepatopancreatobiliary Center,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 100044,China

出　　处：《World Journal of Gastroenterology》2022年第20期2214-2226,共13页世界胃肠病学杂志（英文版）

基　　金：Supported by National Natural Science Foundation of China,No. 81870406;Nature Science Foundation of Beijing Municipality,No. 7182174

摘　　要：BACKGROUND Direct acting antiviral(DAA)therapy has enabled hepatitis C virus infection to become curable,while histological changes remain uncontained.Few valid noninvasive methods can be confirmed for use in surveillance.Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid(Gd-EOB-DTPA)is a liver-specific magnetic resonance imaging(MRI)contrast,related to liver function in the hepatobiliary phase(HBP).Whether Gd-EOB-DTPA-enhanced MRI can be used in the diagnosis and follow up of hepatic fibrosis in patients with chronic hepatitis C(CHC)has not been investigated.AIM To investigate the diagnostic and follow-up values of Gd-EOB-DTPA-enhanced MRI for hepatic histology in patients with CHC.METHODS Patients with CHC were invited to undergo Gd-EOB-DTPA-enhanced MRI and liver biopsy before treatment,and those with paired qualified MRI and liver biopsy specimens were included.Transient elastography(TE)and blood tests were also arranged.Patients treated with DAAs who achieved 24-wk sustained virological response(SVR)underwent Gd-EOB-DTPA-enhanced MRI and liver biopsy again.The signal intensity(SI)of the liver and muscle were measured in the unenhanced phase(UEP)(SI_(UEP-liver),SI_(UEP-muscle))and HBP(SI_(HBP-liver),SI_(HBP-muscle))via MRI.The contrast enhancement index(CEI)was calculated as[(SI_(HBP-liver)/SI_(HBP-muscle))]/[(SI_(UEP-liver)/SI_(UEP-muscle))].Liver stiffness measurement(LSM)was confirmed with TE.Serologic markers,aspartate aminotransferase-to-platelet ratio index(APRI)and Fibrosis-4(FIB-4),were also calculated according to blood tests.The grade of inflammation and stage of fibrosis were evaluated with the modified histology activity index(mHAI)and Ishak fibrosis score,respectively.Fibrosis regression was defined as a≥1-point decrease in the Ishak fibrosis score.The correlation between the CEI and liver pathology was evaluated.The diagnostic and follow-up values of the CEI,LSM,and serologic markers were compared.RESULTS Thirty-nine patients with CHC were enrolled[average age,42.3±14.4 years;20/39(

关 键 词：Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging Contrast enhancement index Hepatitis C virus Direct acting antiviral Sustained virological response Fibrosis regression 

分 类 号：R512.63[医药卫生—内科学]