基于MRI的肝表面结节曲率值对肝硬化患者肝功能评估的价值  

Value of curvature value of liver surface nodularity based on MRI in liver function evaluation of liver cirrhosis

作　　者：王楠[1] 黄继随 刘宇卉 崔英超 许岂豪 宋清伟[1] 雷娜 刘爱连[1] WANG Nan;HUANG Jisui;LIU Yuhui;CUI Yingchao;XU Qihao;SONG Qingwei;LEI Na;LIU Ailian(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116000,China;Capital Normal University,Beijing 100000,China;Dalian Medical University,Dalian,Liaoning Province 116000,China;Dalian University of Technology,Dalian,Liaoning Province 116000,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116000 [2]首都师范大学,北京100000 [3]大连医科大学,辽宁大连116000 [4]大连理工大学,辽宁大连116000

出　　处：《实用放射学杂志》2024年第4期581-585,共5页Journal of Practical Radiology

摘　　要：目的探讨基于MRI的肝表面结节(LSN)曲率值对肝硬化患者肝功能评估的价值。方法回顾性分析行3.0T MR上腹部检查的患者,肝功能正常及肝硬化患者,采用肝功能Child-Pugh分级标准对肝硬化患者进行评分。最终分为正常肝脏,代偿期肝硬化和失代偿期肝硬化3组。将3D水脂分离梯度回波(mDixon-FFE)序列的水相图以DICOM格式拷贝,由2名观察者分别使用ITK软件手动绘制全层肝脏边缘。使用matlab自编代码进行后续分析,得到LSN曲率值。组间曲率值比较利用Kruskal-Wallis H检验。绘制受试者工作特征(ROC)曲线,得出曲线下面积(AUC)。相关性分析采用Spearman检验。结果3组间LSN曲率值逐渐增大(P<0.05)。正常肝脏与代偿期肝硬化比较,诊断代偿期肝硬化的AUC为0.84,敏感度为72.7%,特异度为89.3%。代偿期肝硬化与失代偿期肝硬化比较,诊断失代偿期肝硬化的AUC为0.91,敏感度为80%,特异度为90.9%。肝硬化患者LSN曲率值和肝功能评分之间呈中度正相关(r=0.63,P=0.002)。结论基于MRI的LSN曲率值能够对肝硬化进行初步肝功能评估,AUC均>0.80,且具有较高的敏感度和特异度。Objective To explore the value of curvature value of liver surface nodularity(LSN)based on MRI in evaluating liver function in patients with liver cirrhosis.Methods A retrospective analysis was made on the patients who underwent upper abdomen MR examination at 3.0T.The normal liver function patients and cirrhosis patients were enrolled in the study and then the Child-Pugh score of the patients were calculated.The patients were divided into three groups:normal liver group,compensated cirrhosis group and decompensated cirrhosis group.The water phase imaging of 3D modified Dixon fast field echo(mDixon-FFE)sequence was copied in DICOM format.ITK software was used to manually draw the full-thickness liver edge by two observers.The curvature value of LSN was obtained by using matlab self compiled code for follow up analysis.Kruskal-Wallis H test was used to compare the curvature value between the groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was obtained.Spearman test was used for the correlation analysis.Results The curvature values of LSN among the normal liver,compensated cirrhosis and decompensated cirrhosis groups gradually increased(P<0.05).Comparing normal liver with compensated cirrhosis,the AUC of diagnosing compensated cirrhosis was 0.84,with the sensitivity of 72.7%and the specificity of 89.3%.Comparing compensated cirrhosis with decompensated cirrhosis,the AUC of diagnosing decompensated cirrhosis was 0.91,with the sensitivity of 80%and the specificity of 90.9%.There was a moderate positive correlation between the curvature value of LSN and liver function score in patients with cirrhosis(r=0.63,P=0.002).Conclusion The curvature value of LSN based on MRI can be used for preliminary evaluation of liver function of liver cirrhosis,with the AUC more than 0.80 and higher sensitivity and specificity.

关 键 词：磁共振成像 肝硬化 肝功能 肝表面结节 

分 类 号：R445[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学] R333.4[医药卫生—临床医学]