关键词: 磁共振, 最小二乘法估计和不对称回波迭代分解水和脂肪的脂肪成像, 乙肝, 肝纤维化分期, 血清学指标

Abstract: Objective To explore the application value of MRI least square estimation and asymmetric echo iterative lipography (MRI-ideal-iq) in combination with serological indicators in the staging of hepatic fibrosis (HF) in patients with chronic hepatitis B. Methods 100 patients with hepatitis B admitted to our hospital from January 2021 to January 2023 were selected in this study. According to the guidelines and liver biopsy results, 100 patients were divided into stage S0-S1 group (n=41), stage S2 group (n=28), stage S3 group (n=17), and stage S4 group (n=14). The IDEAL-IQ parameters, serum indicators such as hyaluronic acid (HA), type IV collagen (CIV), laminin (LN), and liver function parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin were compared among the four groups of patients. The value of IDEAL-IQ parameters combined with serological indicators in predicting early liver cirrhosis (S4 stage) was evaluated by receiver operating characteristic curve (ROC) method. The relationship between IDEAL-IQ parameters, serological indicators, and HF were evaluated by Correlation analysis. Results The FF, R2^* value, HA, and CIV levels were (1.51±0.33)%, (54.58±8.15)Hz, (139.05±60.57)μg/L, and (88.24±24.78)ng/mL in S0 to S1 group, respectively; (2.01±0.42)%, (69.07±7.44)Hz, (337.56±113.24)μg/L, and (106.04±30.21)ng/mL in S2 group; (3.07±0.46)%, (94.55±10.53)Hz, (416.08±124.51)μg/L, and (134.07±38.76)ng/ml in S3 group; (4.32±0.53)%, (111.14±11.42)Hz, (583.76±150.54)μg/L, and (190.06±42.83)ng/mL in S4 group. There was a statistically significant difference between the four groups (F=188.442, 178.839, 75.985, 38.451, P<0.05); There was no significant difference in serum levels of LN among the four groups (P>0.05). By ROC analysis it was shown that the areas under the curves of FF, R2^* value, serum HA and CIV levels for predicting early cirrhosis were 0.777, 0.782, 0.819, and 0.744, respectively, with the optimal cutoff values of FF≥3.560%, R2^* value≥102.950 Hz, HA≥517.210 μg/L, and CIV≥173.895 ng/mL, all P<0.05. The area under the curve of a combined prediction for early liver cirrhosis was 0.832, with a sensitivity of 0.786, both were higher than those of the single indicators. The levels of ALT, AST, and albumin were (134.65±37.85) U/L, (74.22±20.57)U/L, and (45.15±3.76)g/L in S0-S1 group, respectively, (192.08±47.52)U/L, (100.25±30.16)U/L, and (43.45±3.01)g/L in S2 group, (214.12±55.63)U/L, (127.13±38.53)U/L, and (40.35±5.24)g/L in S3 group, (159.14±43.71]U/L, (101.54±33.48) U/L, (37.42±3.65)g/L in S4 group, The differences between the four groups were statistically significant (F=18.341, 14.667, 16.786, P<0.05). By correlation analysis, it was found that FF, R2^* values, serum HA and CIV levels were positively correlated with HF staging (P<0.05); There was no significant correlation between serum LN levels and HF stagings (P>0.05). Conclusion The FF, R2^* values, as well as serum HA and CIV levels show significant differences in patients with different HF stages, which may reflect the degree of HF. Moreover, the combination of them has high sensitivity in diagnosing early cirrhosis.    

Key words: Magnetic resonance, Least squares estimation and asymmetric echo iterative decomposition for fat imaging of water and fat, Hepatitis B, Staging of liver fibrosis, Serological indicators