CAJ | 학술논문

目的探讨3.0TMR弹性成像(MRE)评价健康志愿者及慢性肝病患者肝弹性值的可靠性及评估者测量结果的一致性.方法采用3.0 T MRE分析24名健康志愿者(无肝病组)及64例临床确诊的慢性肝病患者(肝病组,其中22例经肝脏穿刺活检证实)肝脏的弹性值.由2名评估者盲法测量肝弹性值,采用组内相关系数(ICC)评价评估者所测肝弹性值的一致性,采用Mann-Whitney U检验分析两组受试者肝弹性值的差异,采用Spearman检验分析病理纤维化分期与肝弹性值之间的相关性.结果2名评估者所测肝弹性值之间具有良好的一致性(ICC=0.99),无肝病组及肝病组受试者的肝弹性值分别为(2.35±0.34) kPa及(4.17±0.47) kPa,二者的差异有统计学意义(U=90.5,P＜0.01).22例行肝穿刺患者肝纤维化分期S0、S1、S2、S3和S4患者分别为3、3、5、5和6例,肝弹性值中位数分别为2.13、3.25、3.82、5.45和7.35 kPa,弹性值与纤维化分期之间具有强相关性(r=0.96,P＜0.01).结论 MRE是一种可靠的测量肝弹性值及评估肝纤维化分期的方法.
목적 탐토3.0TMR탄성성상(MRE)평개건강지원자급만성간병환자간탄성치적가고성급평고자측량결과적일치성.방법채용3.0 T MRE분석24명건강지원자(무간병조)급64례림상학진적만성간병환자(간병조,기중22례경간장천자활검증실)간장적탄성치.유2명평고자맹법측량간탄성치,채용조내상관계수(ICC)평개평고자소측간탄성치적일치성,채용Mann-Whitney U검험분석량조수시자간탄성치적차이,채용Spearman검험분석병리섬유화분기여간탄성치지간적상관성.결과2명평고자소측간탄성치지간구유량호적일치성(ICC=0.99),무간병조급간병조수시자적간탄성치분별위(2.35±0.34) kPa급(4.17±0.47) kPa,이자적차이유통계학의의(U=90.5,P＜0.01).22례행간천자환자간섬유화분기S0、S1、S2、S3화S4환자분별위3、3、5、5화6례,간탄성치중위수분별위2.13、3.25、3.82、5.45화7.35 kPa,탄성치여섬유화분기지간구유강상관성(r=0.96,P＜0.01).결론 MRE시일충가고적측량간탄성치급평고간섬유화분기적방법.
Objective To estimate reliability of magnetic resonance elastography (MRE) in measuring liver stiffness of volunteers and patients with chronic liver disease and to assess inter-rater consistency.Methods MRE was performed on a 3.0 T scanner in all subjects,including 24 volunteers (control group) and 64 patients with liver disease (chronic liver disease group).Liver stiffness was measured blindly by two raters.The pathological fibrosis score was applied as a standard reference for liver fibrosis in 22 patients.The intraclass correlation coefficient (ICC) was used to evaluate inter-rater reliability.The differences of liver stiffness between two groups were evaluated using non-parametric MannWhitney U test.Spearman analysis was used to analyze the correlation between fibrosis stages and liver stiffness.Results The intraclass correlation coefficient of liver stiffness was perfect (ICC =0.99,P ＜ 0.01)between two raters.There was significant difference of mean stiffness between control group and patient group (U =90.5,P ＜0.01) with(2.35 ±0.34) kPa and(4.17 ± 0.47) kPa,respectively.The correlation between fibrosis stage (3,3,5,5 and 6 patients in fibrosis stage S0,S1,S2,S3 and S4) and stiffness (2.13,3.25,3.82,5.45 and 7.35 kPa) was very strong (r =0.96,P ＜0.01).Conclusion MRE is a reliable and promising tool to measure liver stiffness and to assess liver fibrosis.