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  

The application of MRI-ideal-iq technique combined with serological indexes in staging hepatic fibrosis in chronic hepatitis B patients

作　　者：刘静[1,2] 郭飞 吴露露[2] 李贺 LIU Jing;GUO Fei;WU Lu-lu;LI He(Bengbu Medical College,Anhui 233030;Magnetic Resonance Room,Huainan First People′s Hospital,Anhui 232000,China;Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Anhui 233003,China;CT Room,the Second People′s Hospital of Bengbu,Anhui 233099,China)

机构地区：[1]蚌埠医学院,安徽233030 [2]淮南市第一人民医院磁共振室 [3]蚌埠医学院第一附属医院放射科 [4]蚌埠市第二人民医院CT室

出　　处：《肝脏》2024年第4期414-418,共5页Chinese Hepatology

基　　金：淮南市科技计划项目(2018A3613)。

摘　　要：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≥517.210μg/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�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≥517.210μg/L,and CIV≥173.895 ng/mL,all P<0.05.The area under

关 键 词：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 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]