磁敏感加权成像评估慢性肝病铁沉积

目的探讨SWI幅度图值评估慢性肝病铁沉积和肝纤维化的可行性及其在诊断慢性肝病中的应用价值。方法对139例慢性肝病患者慢性肝病组,包括77例慢性肝炎(肝炎亚组)和62例肝硬化(肝硬化亚组)]以及无肝病对照81人(对照组)行常规MR序列及SWI扫描,并采集实验室资料。测量并比较慢性肝病组各亚组与对照组幅度图的肝肌信号强度比(LMR)。ROC曲线分析LMR诊断慢性肝病的效能。比较各组实验室指标和LMR的差异,同时比较不同肝纤维化分级者的LMR。以多元线性回归分析LMR的独立影响因素。结果肝炎亚组、肝硬化亚组和对照组LMR总体差异有统计学意义(P0.001),对照组LMR分别高于肝炎亚组和肝硬化亚组(P均0.01),肝炎亚组LMR高于肝硬化亚组(P=0.002)。ROC曲线分析LMR诊断慢性肝病的敏感度和特异度分别为80.24%和56.13%。不同肝纤维化分级LMR患者差异无统计学意义(P0.05)。肝铁沉积是LMR的独立影响因素(P=0.005)。结论 SWI可初步判断肝脏铁质沉积,诊断慢性肝病具有一定应用价值。

Susceptibility-weighted imaging in evaluating iron deposition in chronic liver disease

Objective To explore the feasibility of SWI in evaluation on iron deposition and liver fibrosis in patients with chronic liver disease (CLD) with magnitude signal intensity. Methods Totally 139 CLD patients (CLD group; including 77 cases with hepatitishepatitis subgroup], 62 cases of liver cirrhosisliver cirrhosis subgroup]) and 81 healthy individuals (control group) underwent routine MRI and SWI, and laboratory data of all subjects were collected. Liver to muscle signal intensity ratio (LMR) was measured and compared. ROC curve analysis was used to evaluate the diagnostic performance of LMR in CLD. The differences of laboratory indexes and LMR in each group were compared, as well as LMR values of different liver fibrosis grades. Multiple linear regression analysis was performed to evaluate independent influence factors of LMR. Results There was significant difference of LMR among CLD subgroups and control group (P<0.001). LMR of the control group was higher than that of the hepatitis subgroup and the liver cirrhosis subgroup (both P<0.01). LMR of hepatitis subgroup was higher than that of liver cirrhosis subgroup (P=0.002). The sensitivity and specificity of LMR for diagnosing CLD was 80.24% and 56.13%, respectively. There was no statistically significant of LMR among patients with different degrees of fibrosis (P>0.05). Liver iron deposition was the independent impact factor of LMR (P=0.005). Conclusion SWI magnitude image can be used to analyze the degree of iron deposition in patients with CLD preliminarily, therefore having curtain application value in diagnosis of CLD.