Abstract：Objective: To explore the value of histogram analysis based on Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA) enhanced MRI hepatobiliary phase in diagnosing and staging liver fibrosis (LF). Methods: Hepatobiliary phase image of 83 patients with pathologically confirmed LF were retrospectively reviewed. MaZda software was used to extract histogram analysis parameters including minimum, maximum, mean, skewness, kurtosis, variance, and nth percentiles. Parameters were compared among different LF stages using receivers operating characteristic curve. Results: Eighty-three patients were included, and 17, 15, 21, 16, and 14 cases were pathologically diagnosed as F0-F4, respectively. Histogram analysis parameters including the 90th (r= 0.554), variance (r= 0.484), mean (r=0.387), 50th (r=0.347), kurtosis (r=0.279) and 99th parameter (r=0.255) of hepatobiliary phase demonstrated significant positive correlation with increasing fibrosis stage (P<0.05). The 90th parameter demonstrated higher diagnostic efficacy than other histogram analysis parameters in fibrosis staging, with an AUC value of 0.79 for ≥ F1, 0.78 for ≥ F2, 0.76 for ≥ F3, and 0.82 for ≥ F4, respectively. Conclusion: Histogram analysis of Gd-EOB-DPTA enhanced MRI hepatobiliary phase provides higher diagnostic value in predicting LF progression and distinguishing LF stages, which may be served as effective imaging alternative in staging HF.
[1] Tacke F,Trautwein C.Mechanisms of liver fibrosis resolution[J].Hepatol,2015,63(4):1038~1039. [2] Tacke F,Weoskirchen R.An update on the recent advances in antifibrotic therapy[J].Expert Rev Gastroenterol Hepatol,2018,12(11):1143~1152. [3] Altamirano A,Barranco B,Mendez N.Management strategies for liver fibrosis[J].Ann Hepatol,2017,16(1):48~56. [4] Czeczok TW,Amam JS,Wood LD,et al.The almost-normal liver biopsy:presentation,clinical associations,and outcome[J].Am Surg Pathol,2017,41(9):1247~1253. [5] Xu XY,Wang WS,Zhang QM,et al.Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B:a systematic review and meta-analysis[J].World Clin Cases,2019,7(15):2022~2037. [6] 李晨霞,刘海甜,李香,等.钆塞酸二钠增强MRI在评估肝功能中的参数选择研究[J].中华实用诊断与治疗杂志,2019,33(12):1212~1216. [7] 张涛,陆健,张学琴,等.钆塞酸二钠增强T1-mapping成像和DWI对肝纤维化分期的评估价值[J].放射学实践,2020,35(2):203~207. [8] 刘克明,刘烁,郭华,等.ADC直方图在家兔肝纤维化模型分期中的可行性研究[J].医学影像学杂志,2019,29(9):1568~1571. [9] Xie T,Zhao Q,Fu C,et al.Differentiation of triple-negative breast cancer from other subtypes through whole-tumor histogram analysis on multiparametric MR imaging[J].Eur Radiol,2019,29(5):2535~2544. [10] Hu F,Yang R,Huang Z,et al.Liver fibrosis:in vivo evaluation using intravoxel incoherent motion-derived histogram metrics with histopathologic findings at 3.0 T[J].Abdom Radiol,2017,42(12):2855~2863. [11] Sheng RF,Jin KP,Yang L,et al.Histogram analysis of diffusion kurtosis magnetic resonance imaging for diagnosis of hepatic fibrosis[J].Korean Radiol,2018,19(5):916~922. [12] Liu HF,Wang Q,Du YN,et al.Dynamic contrast-enhanced MRI with Gd-EOB-DTPA for the quantitative assessment of early-stage liver fibrosis induced by carbon tetrachloride in rabbits[J].Magn Reson Imaging,2020,70(5):57~63. [13] Zheng Y,Xu YS,Liu Z,et al.Whole-liver apparent diffusion coefficient histogram analysis for the diagnosis and staging of liver fibrosis[J].Magn Reson Imaging,2020,51(6):1745~1754. [14] Yang ZX,Liang HY,Hu XX,et al.Feasibility of histogram analysis of susceptibility-weighted MRI for staging of liver fibrosis[J].Diagn and Interv Radiol,2016,22(4):301~307. [15] Mehta KJ,Famaud SJ,Sharp PA.Iron and liver fibrosis:mechanistic and clinical aspects[J].World Gastroenterol,2019,25(5):521~538.
2022, Vol. 28 
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