磁共振多回波Dixon技术脂肪含量测量联合血清学指标对早期肝纤维化的诊断价值  

Diagnostic value of fat content measurement by magnetic resonance multi-echo Dixon technique combined with serological indicators for early liver fibrosis

作　　者：胡勤勤 杨华[1] 陈家飞 胡晓飞 王洁 刘慧敏 HU Qin-qin;YANG Hua;CHEN Jia-fei;HU Xiao-fei;WANG Jie;LIU Hui-min(Department of Radiology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Radiology,First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Infectious Disease,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]重庆市中医院放射科,重庆400021 [2]陆军军医大学第一附属医院放射科,重庆400038 [3]陆军军医大学第一附属医院感染科,重庆400038

出　　处：《局解手术学杂志》2025年第3期245-249,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然科学基金面上项目(CSTB2024NSCQ-MSX0230);重庆市江北区科卫联合医学科研项目(西医、公共卫生)(JBKW2023xy001)。

摘　　要：目的分析基于磁共振多回波Dixon(ME-Dixon)技术的脂肪含量测量联合血清学指标对早期肝纤维化的诊断价值。方法纳入陆军军医大学第一附属医院2019年8月至2021年10月行肝组织穿刺活检的早期肝纤维化患者78例,根据病理结果将早期肝纤维化患者分为S0组(n=21)、S1组(n=32)、S2组(n=25)。同时收集患者完整影像检查结果(包含ME-Dixon序列)和实验室检查结果[包括透明质酸酶(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ-谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)],并通过ME-Dixon技术测量肝脂肪分数(HFF)。采用单因素方差分析3组间HFF及血清学指标的差异,然后选取单因素分析中有统计学差异的因素绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估其诊断肝纤维化及早期肝纤维化程度的价值。结果S0、S1、S2组间PCⅢ、LN、AST、ALT比较差异无统计学意义(P>0.05),HFF、HA、CⅣ、GGT、ALP比较差异有统计学意义(P<0.05),而S2组HA、CⅣ、GGT、ALP明显高于S0、S1组(P<0.05)。ROC曲线分析显示,上述指标在判断肝纤维化和早期肝纤维化程度中按AUC大小依次为HFF+GGT(0.72)>HFF(0.68)>GGT(0.61)>CⅣ(0.54)>ALP(0.53)>HA(0.48)和HA+CⅣ(0.71)>CⅣ(0.68)>HA(0.66)>GGT(0.61)>ALP(0.59)>HFF(0.46)。结论基于磁共振ME-Dixon技术的脂肪含量测量联合血清学指标对早期肝纤维化诊断具有重要参考价值,在临床诊疗中有一定指导作用。Objective To analyze the diagnostic value of fat content measurement based on magnetic resonance multi-echo Dixon(MEDixon)technique combined with serological indicators for early liver fibrosis.Methods A total of 78 patients with early liver fibrosis who underwent liver biopsy at the First Affiliated Hospital of Army Medical University from August 2019 to October 2021 were included.According to the pathological results,the patients with early liver fibrosis were divided into the S0 group(n=21),the S1 group(n=32),and the S2 group(n=25).Meanwhile,the complete imaging examination results(including ME-Dixon sequence)and laboratory examination results[including hyaluronic acid(HA),procollagenⅢ(PCⅢ),collagenⅣ(CⅣ),laminin(LN),aspartate transaminase(AST),alanine aminotransferase(ALT),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP)]were collected.And the hepatic fat fraction(HFF)was measured by ME-Dixon technique.One-way ANOVA was used to analyze the differences in HFF and serological indicators among the three groups,and then factors with statistical differences in the univariate analysis were selected to draw receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was calculated to evaluate their value in the diagnosis of liver fibrosis and the degree of early liver fibrosis.Results There was no statistically significant difference in the PCⅢ,LN,AST,or ALT among the S0,S1,and S2 groups(P>0.05),while there were statistically significant differences in the HFF,HA,CⅣ,GGT,and ALP(P<0.05),and the levels of HA,CⅣ,GGT,and ALP in the S2 group were significantly higher than those in the S0 and S1 groups(P<0.05).ROC curve analysis showed that the above indicators for diagnosing liver fibrosis and the degree of early liver fibrosis based on AUC values were in the following order:HFF+GGT(0.72)>HFF(0.68)>GGT(0.61)>CⅣ(0.54)>ALP(0.53)>HA(0.48)and HA+CⅣ(0.71)>CⅣ(0.68)>HA(0.66)>GGT(0.61)>ALP(0.59)>HFF(0.46).Conclusion The fat content measurement based on magnetic resonance ME-Dixon tech

关 键 词：ME-Dixon技术 肝脂肪分数 血清学指标 早期肝纤维化 

分 类 号：R445.2[医药卫生—影像医学与核医学]