磁共振弹力值对非酒精性脂肪性肝病患者肝纤维化的定量评估及其与碱性磷酸酶天冬氨酸转氨酶的关系  

Quantitative evaluation of liver fibrosis in patients with nonalcoholic fatty liver disease by magnetic resonance elastography and its relationship with alkaline-phosphatase,aspartate-aminotransferase

作　　者：卢志鹏 Lu Zhipeng(Medical Imaging Department,Zhengzhou People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州市人民医院医学影像科,郑州450003

出　　处：《实用医技杂志》2025年第2期101-105,共5页Journal of Practical Medical Techniques

摘　　要：目的分析磁共振弹力值对非酒精性脂肪性肝病(NAFLD)患者肝纤维化的定量评估及其与碱性磷酸酶(ALP)和天冬氨酸转氨酶(AST)指标的关系。方法对我院在2023年1月至12月收治的50例NAFLD患者进行分析,手术前给予患者常规腹部、磁共振弹力成像(MRE)及ALP、AST检测,分析患者临床相关数据。结果穿刺结果显示,肝脏纤维化程度分为无纤维化期(S0)7例、轻度纤维化期(S1)12例、显著纤维化期(S2)12例、进展期纤维化期(S3)11例和肝硬化期(S4)8例。在NAFLD患者中,肝脏磁共振弹力值在轻度肝纤维化、显著肝纤维化、进展期肝纤维化和肝硬化的患者中差异均有统计学意义(P均<0.05)。磁共振弹力值对于诊断轻度肝纤维化、显著肝纤维化、进展期肝纤维化和肝硬化的准确性(95%CI)分别为0.90(0.81,0.96)、0.91(0.83,0.98)、0.93(0.86,1.00)和0.93(0.84,1.00)。其中,对于诊断肝硬化,灵敏度最高;而对于诊断轻度肝纤维化,特异度最大。Pearson线性相关性分析结果显示,在NAFLD患者中,肝脏磁共振弹力值与总胆红素、球蛋白、总蛋白、白蛋白无明显相关性(r=0.191、0.122、0.262、0.153,P均>0.05),与ALP呈弱正相关(r=0.447,P<0.05),与AST呈中等正相关(r=0.562,P<0.05)。结论MRE可以作为NAFLD患者肝纤维化的有效评估工具,并且与ALP和AST存在一定的相关性。特别是在肝硬化的诊断中,MRE显示出较高的灵敏度,对早期诊断和治疗干预具有重要意义。Objective To analyze the quantitative evaluation of magnetic resonance elastography(MRE)values in assessing liver fibrosis in patients with non-alcoholic fatty liver disease(NAFLD)and to investigate its relationship with alkaline phosphatase(ALP)and aspartate aminotransferase(AST)levels.Methods Fifty patients with NAFLD admitted to our hospital from January 2023 to December 2023 were analyzed.Routine abdominal,magnetic resonance elastography(MRE),ALP and AST were detected before operation,and the clinical data of the patients were analyzed.Results The results showed that the degree of liver fibrosis was divided into 7 cases of non-fibrotic stage(S0),12 cases of mild fibrotic stage(S1),12 cases of significant fibrotic stage(S2),11 cases of advanced fibrotic stage(S3)and 8 cases of cirrhosis stage(S4).In NAFLD patients,there were significant differences in liver magnetic resonance elasticity values in the diagnosis of mild liver fibrosis,significant liver fibrosis,advanced liver fibrosis and cirrhosis(all P<0.05).The accuracy of MRI elasticity values in the diagnosis of mild liver fibrosis,significant liver fibrosis,advanced liver fibrosis and cirrhosis were 0.90(95%CI 0.81,0.96),0.91(95%CI 0.83,0.98),0.93(95%CI 0.86,1.00)and 0.93(95%CI 0.84~),respectively 1.00.Among them,the sensitivity of liver cirrhosis was the highest;for the diagnosis of mild liver fibrosis,the specificity was the greatest.Pearson linear correlation analysis showed that in NAFLD patients,there was no significant correlation between liver magnetic resonance elasticity value and total bilirubin,globulin,total protein and albumin(r=0.191,0.122,0.262,0.153,P>0.05),and there was a weak positive correlation with ALP(r=0.447,P<0.05),was moderately positive correlated with AST(r=0.562,P<0.05).Conclusion MRE can be used as an effective evaluation tool for liver fibrosis in NAFLD patients,and it is correlated with ALP and AST.Especially in the diagnosis of cirrhosis,MRE shows high sensitivity and is of great significance for early diagnosis and therapeu

关 键 词：非酒精性脂肪性肝病 弹性成像技术 肝纤维化 碱性磷酸酶 天冬氨酸转氨酶 

分 类 号：R575.5[医药卫生—消化系统] R445.2[医药卫生—内科学] R575.2[医药卫生—临床医学]