The clinical value of dual-energy CT enhancement and magnetic resonance elastography in the diagnosis of hepatitis B liver fibrosis

doi:10.19871/j.cnki.xfcrbzz.2024.03.012

Abstract

Abstract: Objective To explore the value of dual energy CT (DECT) enhanced scanning and magnetic resonance elastography (MRE) in the diagnosis of hepatitis B liver fibrosis,and provide reference for clinical application. Method From July 2022 to July 2023, a retrospective study was carried out on the clinical diagnosis and treatment data of 85 patients with chronic hepatitis B diagnosed and treated in Department of Radiography of Luohu Hospital of Traditional Chinese Medicine, Guangdong Shenzhen. All patients in this group underwent DECT scans and MRE examinations. Based on the pathological biopsy results as the gold standard, they were divided into S0 group, S1-S2 group, and S3-S4 group according to the severity of liver fibrosis. The MRE elasticity values, arterial hepatic parenchymal iodine concentration (Ia), portal venous hepatic parenchymal iodine concentration (Ip), and hepatic arterial iodine fraction (AIF) were compared among the three groups; Analyze the correlation between liver fibrosis grading and the above indicators through Spearman correlation coefficient, and analyze the efficacy of clinical diagnosis. Result Pathological biopsies of 105 patients in this group showed that there were 28 cases in group S0, 35 cases in group S1-S2, and 22 cases in group S3-S4. There was no significant difference in the basic clinical data of the three groups (P>0.05). The MRE elastic value, Ia, Ip and AIF of S0 group, S1-S2 group and S3-S4 group were significantly different (P<0.05). Spearman correlation analysis showed that the severity of hepatitis B fibrosis was positively correlated with MRE elasticity score, Ia and AIF (r=0.705, 0.543, 0.685, P<0.05), and negatively correlated with Ip (r=-0.607, P<0.05). The sensitivity, specificity and accuracy of MRE and DECT enhanced scanning in the diagnosis of hepatitis B fibrosis were significant (P<0.05). According to ROC curve analysis, the AUC of DECT enhanced scan, MRE and combined diagnosis of HBV fibrosis were 0.769、0.833、0.926, respectively. Conclusion In the diagnosis of hepatitis B liver fibrosis,DECT enhanced scanning and MRE examination have good results,and the combined diagnosis of both can improve the diagnostic efficiency and has important clinical value.

Key words: Dual-energy CT enhancement, Magnetic resonance elastography, Hepatitis B liver fibrosis, Diagnostic efficiency

CLC Number:

Gu Xiaoli, Pan Qiuhe, Chen Jianbo, Guo Qing. The clinical value of dual-energy CT enhancement and magnetic resonance elastography in the diagnosis of hepatitis B liver fibrosis[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(3): 56-60.

References

[1] 黄伟强,董常峰.弹性成像及血生化指标对肝纤维化的评价及研究进展[J/CD].新发传染病电子杂志,2017,2(2):117-121.
[2] SANDRASEGARAN K, TERRITO P, ELKADY RM, et al.Does intravoxel incoherent motion reliably stage hepatic fibrosis, steatosis, and inflammation?[J]. AbdomRadiol, 2017, 43(3):600-606.
[3] YOON JH, LEE JM, LEE KB, et al.Comparison of monoexponential, intravoxel incoherent motion diffusionweighted imaging and diffusion kurtosis imaging for assessment of hepatic fibrosis[J]. ActaRadiol, 2019, 25(1):1-9.
[4] 杨元,董美衬,李荣海,等.肝纤维化指标的诊断价值及模型建立[J].河北医药,2023,45(15):2310-2312+2316.
[5] 刘逍. 超声瞬时弹性成像联合超声造影技术对晚期肝吸虫病肝纤维化诊断运用分析[J].中国地方病防治,2023,38(4):327-329.
[6] 周晓丽,施文娟,张妍,等.FibroScan对ALT<2×ULN慢性乙型肝炎患者肝纤维化程度的诊断价值[J].甘肃医药,2023,42(7):628-629+642.
[7] 杜艳妮, 吕志彬, 关春爽,等.钆塞酸二钠增强MRI功能性肝脏影像评分影像征象与Child-Turcotte-Pugh分级评估肝功能的对照研究[J].临床放射学杂志, 2021, 40(11):2134-2138.
[8] 陈然,吴隽. 剪切波弹性成像与门静脉血流动力学参数对慢性肝炎肝纤维化的诊断价值[J].影像研究与医学应用,2023,7(12):47-49.
[9] BRANCATELLI G, FEDERLE MP, AMBROSINI R, et al.Cirrhosis: CT and MR imaging evaluation[J]. Eur J Radiol, 2007, 61(1): 57-69.
[10] CHIN JL, PAVLIDES M, MOOLLA A, et al.Non-invasive markers of liver fibrosis: adjuncts or alternatives to liver biopsy[J]? Front Pharmacol, 2016, 7(159): 1-19.
[11] 段秋景,瞿国英. 瞬时弹性成像技术在肝纤维化及脂肪肝诊断中的价值[J].名医,2023(5):30-32.
[12] 曹丽敏,赵玉东. 应用剪切波弹性成像评估慢性乙型肝炎肝纤维化的准确性及影响因素[J].实用医技杂志,2023,30(3):167-170.
[13] MATHEW RP, VENKATESH SK.Imaging of Hepatic Fibrosis[J]. Current Gastroenterol Rep, 2018, 20(10):1-10.
[14] 金良红, 李兴杰, 关红博, 等.双能量CT碘定量结合动态对比增强MRI评估肝硬化患者肝脏血流动力学和肝功能临床价值研究[J].实用肝脏病杂志, 2019, 22(5):712-715.
[15] 石桥, 谢婷婷, 袁知东, 等. 双能量CT碘定量参数评估肝硬化患者肝脏血流灌注重分布及肝功能的临床价值[J]. 放射学实践, 2017, 32(7): 734-738.
[16] KIM BH, LEE JM, LEE YJ, et al.MR elastography for noninvasive assessment of hepatic fibrosis: experience from a tertiary center in Asia[J]. J MagnReson Imaging, 2011, 34(5): 1110-1116.
[17] GODFREY EM, PATTERSON AJ, PRIEST AN, et al.A comparison of MR elastography and 31P MR spectroscopy with histological staging of liver fibrosis[J]. EurRadiol, 2012, 22(12): 2790-2797.
[18] ICHIKAWA S, MOTOSUGI U, ICHIKAWA T, et al.Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C[J]. MagnReson Med Sci, 2012, 11(4): 291-297.
[19] CHOI YR, LEE JM, YOON JH, et al.Comparison of magnetic resonance elastography and gadoxetate disodium-enhanced magnetic resonance imaging for the evaluation of hepatic fibrosis[J]. InvesRadiol, 2013, 48(8): 607-613.
[20] TANG A, CLOUTIER G, SZEVERENYI NM, et al.Ultrasound elastographyandmrelastography for assessing liver fibrosis: Part 2, diagnosticperformance, confounders, and future directions[J]. AJR Am JRoentgenol, 2015, 205(1): 33-40.