Magneticresonanceelastographyisaccurateindetectingadvancedfibrosisinautoimmunehepatitis

摘要： Toassessthevalueofmagneticresonanceelastography(MRE)indetectingadvancedfibrosis/cirrhosisinautoimmunehepatitis(AIH).METHODSInthisretrospectivestudy,36patients(19treatedand17untreated)withhistologicallyconfirmedAIHandliverbiopsyperformedwithin3moofMREwereidentifiedatatertiarycarereferralcenter.Liverstiffness(LS)withMREwascalculatedbyaradiologist,andinflammationgradeandfibrosisstageinliverbiopsywasassessedbyapathologistinablindedfashion.Tworadiologistsevaluatedmorphologicalfeaturesofcirrhosisonconventionalmagneticresonanceimaging(MRI).AccuracyofMREwascomparedtolaboratorymarkersandMRIfordetectionofadvancedfibrosis/cirrhosis.RESULTSLiverfibrosisstagesof0,1,2,3and4werepresentin4,6,7,6and13patientsrespectively.Therewerenosignificantdifferencesindistributionoffibrosisstageandinflammationgradebetweentreatedanduntreatedpatientgroups.LSwithMREdemonstratedstrongercorrelationwithliverfibrosisstageincomparisontolaboratorymarkersforchronicliverdisease(r=0.88vs-0.48-0.70).AtrendofdecreasedmeanLSintreatedpatientscomparedtountreatedpatientswasobserved(3.7kPavs3.84kPa)butwasnotstatisticallysignificant.MREhadanaccuracy/sensitivity/specificity/positivepredictivevalue/negativepredictivevalueof0.97/90%/100%/100%/90%and0.98/92.3%/96%/92.3%/96%fordetectionofadvancedfibrosisandcirrhosis,respectively.TheperformanceofMREwassignificantlybetterthanlaboratorytestsfordetectionofadvancedfibrosis(0.97vs0.53-0.80,P<0.01),andcirrhosis(0.98vs0.58-0.80,P<0.01)andbetterthanconventionalMRIfordiagnosisofcirrhosis(0.98vs0.78,P=0.002).CONCLUSIONMREisapromisingmodalityfordetectionofadvancedfibrosisandcirrhosisinpatientswithAIHwithsuperiordiagnosticaccuracycomparedtolaboratoryassessmentandMRI. （共10頁）