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目的利用家兔肝纤维化模型评价磁共振弹性成像(MRE)在肝纤维化(HF)病理分期中的价值方法建立肝纤维化实验组(n=32)、实验补充组(n=12)、正常对照组(n=15)。对实验组及正常对照兔行常规MRI及MRE检查,测量肝实质的硬度(LS)值。HF组实验兔皮下注射50%CCl4后的第4、5、6、10周分别随机选择8只行MRI扫描。以肝脏纤维化病理组织学诊断为标准,评价第4、5、6、10周MRE与HF病理分期的相关性,并采用ROC曲线分析MRE的诊断准确性。结果不同分期HF的LS值之间存在显著差异(P<0.001),随着HF分期加重,LS值增加。LS与HF分期存在明显相关性(r=0.948,P<0.001)。LS区分各组别HF的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为:≥S1期93.8%、93.3%、93.6%、96.8%、87.5%;≥S2期95.8%、95.7%、95.7%、95.8%、95.7%;≥S3期93.8%、96.8%、95.8%、93.8%、98.8%;S4期100%、97.4%、97.9%、100%、88.9%。结论 MRE作为一种安全、可靠地无创性HF分期技术,可为临床诊治、纵向研究提供一种重要的补充手段。
Objective To evaluate the value of magnetic resonance elastography (MRE) in the pathological stage of hepatic fibrosis (HF) by using rabbit liver fibrosis model.Methods The liver fibrosis experimental group (n = 32), experimental supplement group (n = 12) Normal control group (n = 15). The experimental group and normal control rabbits routine MRI and MRE examination, measurement of liver parenchyma hardness (LS) value. HF group rabbits were subcutaneously injected with 50% CCl4 after 4, 5, 6, 10 weeks were randomly selected 8 line MRI scan. Histopathological diagnosis of liver fibrosis as the standard, evaluate the 4th, 5th, 6th and 10th weeks MRE and HF pathological staging, and the use of ROC curve analysis MRE diagnostic accuracy. Results There was a significant difference (P <0.001) between the LS values of different stages of HF. With the increase of HF stage, LS value increased. There was a significant correlation between LS and HF staging (r = 0.948, P <0.001). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of LS in differentiating HF were 93.8%, 93.3%, 93.6%, 96.8%, 87.5% 95.7%, 95.7%, 95.8%, 95.7%; 93.3%, 96.8%, 95.8%, 93.8%, 98.8% of S3 period; 100%, 97.4%, 97.9%, 100%, 88.9% of S4 stage. Conclusion MRE, as a safe and reliable noninvasive HF staging technique, can provide an important complement to clinical diagnosis and longitudinal study.