CAJ | 학술논문

目的：初步探讨3.0T MR磁化传递成像（MTI）技术评价肝纤维化程度的价值。方法：选取肝穿诊断肝纤维化者27例，代偿期肝硬化患者14例及健康人10例行磁化传递成像（MTI）检查，据肝纤维化程度分6组：S0（健康人，10例）、S1（5例）、S2（7例）、S3（8例）、S4（7例）、S5（代偿期肝硬化，14例），通过测量MR信号强度，计算获得各受试者肝脏磁化传递率（MTR），分析各组间MTR值差异及其与肝脏纤维化、炎症程度的相关性；采用受试者工作特征曲线（ROC曲线）分析MTR值诊断肝纤维化、肝硬化程度的能力。结果：MTR值与肝纤维化程度及炎症程度均有正相关趋势（P≤0.001），S0、S 1、S2组间及S3、S4、S5组间MTR值无统计学差异，S0与S3、S4、S5之间及S 1＋2与S3＋4＋5之间MTR值有统计学差异；ROC曲线显示MTR值评价中重度肝纤维化（S3＋4＋5）有统计学意义（P＝0.000），以MTR≥0.077诊断S≥3的敏感性为69.0％、特异性为90.9％。结论：MTR尚不能诊断早期轻度肝纤维化，但对鉴别轻度肝纤维化与中重度肝纤维化及肝硬化有一定的临床价值，可与临床生化等检查结合作为诊断肝纤维化的补充手段。
목적：초보탐토3.0T MR자화전체성상（MTI）기술평개간섬유화정도적개치。방법：선취간천진단간섬유화자27례，대상기간경화환자14례급건강인10례행자화전체성상（MTI）검사，거간섬유화정도분6조：S0（건강인，10례）、S1（5례）、S2（7례）、S3（8례）、S4（7례）、S5（대상기간경화，14례），통과측량MR신호강도，계산획득각수시자간장자화전체솔（MTR），분석각조간MTR치차이급기여간장섬유화、염증정도적상관성；채용수시자공작특정곡선（ROC곡선）분석MTR치진단간섬유화、간경화정도적능력。결과：MTR치여간섬유화정도급염증정도균유정상관추세（P≤0.001），S0、S 1、S2조간급S3、S4、S5조간MTR치무통계학차이，S0여S3、S4、S5지간급S 1＋2여S3＋4＋5지간MTR치유통계학차이；ROC곡선현시MTR치평개중중도간섬유화（S3＋4＋5）유통계학의의（P＝0.000），이MTR≥0.077진단S≥3적민감성위69.0％、특이성위90.9％。결론：MTR상불능진단조기경도간섬유화，단대감별경도간섬유화여중중도간섬유화급간경화유일정적림상개치，가여림상생화등검사결합작위진단간섬유화적보충수단。
Aim:To investigate the value of 3.0T MR magnetization transfer imaging (MTI)for evalu-ating liver fibrosis.Methods:Magnetization transfer imaging (MTI)was performed in 27 liver fibrosis bi-opsy proven,14 patients with decompensated cirrhosis and 10 healthy volunteers.All subjects were divid-ed into 6 groups according to the degree of liver fibrosis,including S0 (normal,10 cases),S1 (5 ca-ses),S2 (7 cases),S3 (8 cases),S4 (7 cases),S5 (decompensated cirrhosis,14 cases).The liver magnetization transfer ratio (MTR)of each subject was calculated,by measuring the MR signal intensi-ty.Analyzed the difference of MTR value between the groups,and the correlation between liver MTR and stage of fibrosis,grade of inflammation.Receiver operating characteristics (ROC )analysis was used to assess the performance of MTR in prediction of liver fibrosis and cirrhosis.Results:There was moderate but significant positive correlation between MTR and fibrosis stage (P≤0.001 ).The MTR values were significant different between S0 versus S3,S4,S5 fibrosis and between S1 +2 versus S3 +4+5 fibrosis. But there were no significant difference among S0,S1,S2 group and among S3,S4,S5 group.ROC a-nalysis showed that liver MTR was a significant predictor of moderate and severe liver fibrosis(stage 3 or greater)(P=0.000),with areas under the curve 0.817,sensitivity 69.0%,and specificity 90.9%, When MTR≥0.077 .Conclusion:MTI can be used for prediction of the presence of moderate and ad-vanced liver fibrosis.It can be used as an additional means of diagnosis of liver fibrosis.