Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study

被引：155

作者：

Loomba, Rohit ^{[1
,2
,3
]}

Cui, Jeffrey ^{[2
]}

Wolfson, Tanya ^{[4
]}

Haufe, William ^{[5
]}

Hooker, Jonathan ^{[5
]}

Szeverenyi, Nikolaus ^{[5
]}

Ang, Brandon ^{[2
]}

Bhatt, Archana ^{[2
]}

Wang, Kang ^{[5
]}

Aryafar, Hamed ^{[6
]}

Behling, Cindy ^{[7
]}

Valasek, Mark A. ^{[8
]}

Lin, Grace Y. ^{[8
]}

Gamst, Anthony ^{[4
]}

Brenner, David A. ^{[1
]}

Yin, Meng ^{[9
]}

Glaser, Kevin J. ^{[9
]}

Ehman, Richard L. ^{[9
]}

Sirlin, Claude B. ^{[5
]}

机构：

[1] Univ Calif San Diego, Dept Med, Div Gastroenterol, La Jolla, CA 92093 USA

[2] Univ Calif San Diego, Dept Med, NAFLD Res Ctr, La Jolla, CA 92093 USA

[3] Univ Calif San Diego, Dept Family & Prevent Med, Div Epidemiol, La Jolla, CA 92093 USA

[4] Univ Calif San Diego, Dept Math, La Jolla, CA 92093 USA

[5] Univ Calif San Diego, Dept Radiol, Liver Imaging Grp, La Jolla, CA 92093 USA

[6] Univ Calif San Diego, Dept Radiol, La Jolla, CA 92093 USA

[7] Sharp Hlth Syst, Dept Pathol, San Diego, CA USA

[8] Univ Calif San Diego, Dept Pathol, La Jolla, CA 92093 USA

[9] Mayo Clin, Dept Radiol, Rochester, MN USA

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2016年 / 111卷 / 07期

关键词：

FATTY LIVER-DISEASE; NONALCOHOLIC STEATOHEPATITIS; HEPATIC STEATOSIS; STIFFNESS MEASUREMENT; MR ELASTOGRAPHY; NATURAL-HISTORY; XL PROBE; ASSOCIATION; BIOPSY; RISK;

D O I：

10.1038/ajg.2016.65

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

OBJECTIVES: Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS: This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D-and 3D-MRE in diagnosing advanced fibrosis. RESULTS: The mean (+/- s.d.) of age and body mass index were 50.2 (+/- 13.6) years and 32.1 (+/- 5.0) kg/m(2), respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P < 0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS: Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D-and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.

引用

页码：986 / 994

页数：9

共 49 条

[1] The natural history of nonalcoholic fatty liver disease: A population-based cohort study [J].

Adams, LA ;

Lymp, JF ;

St Sauver, J ;

Sanderson, SO ;

Lindor, KD ;

Feldstein, A ;

Angulo, P .

GASTROENTEROLOGY, 2005, 129 (01) :113-121

[2] The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD [J].

Angulo, Paul ;

Hui, Jason M. ;

Marchesini, Giulio ;

Bugianesi, Ellisabetta ;

George, Jacob ;

Farrell, Geoffrey C. ;

Enders, Felicity ;

Saksena, Sushma ;

Burt, Alastair D. ;

Bida, John P. ;

Lindor, Keith ;

Sanderson, Schuyler O. ;

Lenzi, Marco ;

Adams, Leon A. ;

Kench, James ;

Therneau, Terry M. ;

Day, Christopher P. .

HEPATOLOGY, 2007, 45 (04) :846-854

[3] Association Between Quantity of Liver Fat and Cardiovascular Risk in Patients With Nonalcoholic Fatty Liver Disease Independent of Nonalcoholic Steatohepatitis [J].

Arulanandan, Ahilan ;

Ang, Brandon ;

Bettencourt, Ricki ;

Hooker, Jonathan ;

Behling, Cynthia ;

Lin, Grace Y. ;

Valasek, Mark A. ;

Ix, Joachim H. ;

Schnabl, Bernd ;

Sirlin, Claude B. ;

Loomba, Rohit .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2015, 13 (08) :1513-+

[4] Update on ultrasound imaging of liver fibrosis [J].

Berzigotti, Annalisa ;

Castera, Laurent .

JOURNAL OF HEPATOLOGY, 2013, 59 (01) :180-182

[5] Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity [J].

Browning, JD ;

Szczepaniak, LS ;

Dobbins, R ;

Nuremberg, P ;

Horton, JD ;

Cohen, JC ;

Grundy, SM ;

Hobbs, HH .

HEPATOLOGY, 2004, 40 (06) :1387-1395

[6] Practices of liver biopsy in France: Results of a prospective nationwide survey [J].

Cadranel, JF ;

Rufat, P ;

Degos, F .

HEPATOLOGY, 2000, 32 (03) :477-481

[7] Noninvasive evaluation of NAFLD [J].

Castera, Laurent ;

Vilgrain, Valerie ;

Angulo, Paul .

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, 2013, 10 (11) :666-675

[8] The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association [J].

Chalasani, Naga ;

Younossi, Zobair ;

Lavine, Joel E. ;

Diehl, Anna Mae ;

Brunt, Elizabeth M. ;

Cusi, Kenneth ;

Charlton, Michael ;

Sanyal, Arun J. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2012, 107 (06) :811-826

[9] Early Detection of Nonalcoholic Steatohepatitis in Patients with Nonalcoholic Fatty Liver Disease by Using MR Elastography [J].

Chen, Jun ;

Talwalkar, Jayant A. ;

Yin, Meng ;

Glaser, Kevin J. ;

Sanderson, Schuyler O. ;

Ehman, Richard L. .

RADIOLOGY, 2011, 259 (03) :749-756

[10] Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study [J].

Cui, J. ;

Ang, B. ;

Haufe, W. ;

Hernandez, C. ;

Verna, E. C. ;

Sirlin, C. B. ;

Loomba, R. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2015, 41 (12) :1271-1280

← 1 2 3 4 5 →