慢性肝病肝组织炎症分级与MR弹性成像测得肝、脾弹力值的相关性研究  

Correlation study between the hepatic inflammation grade and liver and spleen stiffness measured by MR elastography in chronic liver diseases

作　　者：王晓培 杨大为[1] 王宇[2] 赵新颜[2] 杨正汉[1] WANG Xiaopei;YANG Dawei;WANG Yu;ZHAO Xinyan;YANG Zhenghan(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Liver Disease Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]首都医科大学附属北京友谊医院肝病中心,北京100050

出　　处：《实用放射学杂志》2022年第12期1982-1985,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目(61871276,62171298,82071876);首都卫生发展科研专项(2018-2-2023);北京市自然科学基金项目(7184199);首都医科大学附属北京友谊医院科研启动基金资助项目(yyqdkt2020-25);北京市医院管理中心临床医学发展专项经费资助项目(ZYLX202101);北京市医院管理局消化内科学科协同发展中心消化专项特色项目(XXT04)。

摘　　要：目的评估慢性肝病炎症分级与磁共振弹性成像(MRE)测得肝、脾弹力值的关系。方法纳入128例行肝、脾MRE检查的慢性肝病患者,后处理后得到肝、脾弹力值。肝穿刺病理学检查分级肝纤维化及炎症。运用方差分析比较各炎症级别间肝、脾弹力值的差异;Spearman相关性分析明确炎症级别与肝、脾弹力值的相关性;一元、多元线性回归分析炎症分级与肝、脾弹力值的定量关系。结果不同炎症级别间肝弹力值有差异(P<0.001),脾弹力值无统计学差异(P=0.16)。炎症分级与肝弹力值相关性一般(r=0.52,P<0.001),与脾弹力值相关性非常低(r=0.24,P=0.008)。一元线性回归分析显示,炎症分级与肝弹力值线性相关(P<0.001),与脾弹力值不存在线性关系(P=0.07);多元线性回归仅纤维化级别为肝弹力值独立影响因素,其回归方程R2=0.61(P<0.001),略低于纤维化、炎症分级联合模型(R2=0.62,P<0.001)。结论炎症分级与MRE测得肝弹力值线性相关,但相关性一般;炎症分级与脾弹力值相关性非常低,提示肝、脾弹力值联合应用有望弥补炎症的干扰。Objective To evaluate the effect of hepatic inflammation on liver and spleen stiffness measured by magnetic resonance elastography(MRE)in patients with chronic liver disease.Methods A total of 128 patients with chronic liver disease were included.All of them underwent MRE of liver and spleen,liver and spleen stiffness were obtained after post-processing.Liver fibrosis and inflammation were graded by liver biopsy.One-way ANOVA was used to compare the differences of live and spleen stiffness among different inflammation grades;Using Spearman correlation analysis to evaluate the correlation between inflammation grade and liver or spleen stiffness;Univariate and multivariate linear regression was used to analyze the quantitative relationship between inflammation grade and liver or spleen stiffness.Results Liver stiffness showed significant difference among different inflammatory grades(P<0.001),spleen stiffness showed no significant difference(P=0.16).The correlation between inflammation grade and liver stiffness was moderate(r=0.52,P<0.001),the correlation between inflammation grade and spleen stiffness was very low(r=0.24,P=0.008).Univariate linear regression analysis showed that the inflammation grade was linearly correlated with liver stiffness(P<0.001),but there was no linear correlation between inflammation grade and spleen stiffness(P=0.07).Multivariate linear regression analysis showed only fibrosis was independently associated with liver stiffness,the regression equation R2=0.61(P<0.001),which was slightly lower than the combined model of fibrosis and inflammation grade(R2=0.62,P<0.001).Conclusion Inflammation grade is linearly correlated with liver stiffness measured by MRE,but the correlation is moderate.The correlation between inflammation grade and spleen stiffness is very low,suggesting that the combined application of liver and spleen stiffness is expected to make up for the interference of inflammation.

关 键 词：肝组织炎症 肝弹力值 脾弹力值 磁共振弹力成像 

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