摘要
目的:探讨非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的病理特征及其与肝脏磁共振成像质子密度脂肪分数(magnetic resonance imaging estimated proton density fat fraction,MRI-PDFF)和肝功能的相关性,并评价MRI-PDFF对NAFLD的诊断价值。方法:收集2021年6月1日—2023年8月30日南京中医药大学附属医院感染科收治的肝脏穿刺病理诊断为NAFLD的患者67例,回顾性分析不同病理脂肪含量及非酒精性脂肪性肝病活动度评分(non-alcoholic fatty liver disease activity score,NAS)下的临床特征,以及病理脂肪含量、NAS、MRI-PDFF、体重指数(body mass index,BMI)及丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)之间的相关性。同时收集33例肝脏病理组织中无脂肪变性的人群作为对照组,检查其肝脏MRI-PDFF水平,利用受试者工作特征(receiver operating characteristics,ROS)曲线分析MRI-MDFF在NAFLD诊断中的价值。结果:不同病理脂肪含量的NAFLD患者年龄、BMI、ALT、AST、MRI-PDFF、NAS评分的差异有统计学意义;不同NAS评分的NAFLD患者BMI、ALT、AST、MRI-PDFF的差异有统计学意义。肝脏MRI-PDFF与病理脂肪含量呈显著相关(r=0.775,P<0.001),与NAS(r=0.478,P<0.001)、BMI(r=0.402,P=0.001)呈中度相关。与对照组相比,MRI-MDFF诊断NAFLD的ROC曲线下面积(area under the curve,AUC)为0.989,灵敏度为0.94,特异度为0.97,最佳截断值为4.42%。结论:MRI-PDFF是一种能较为准确反映肝脏脂肪含量且无创的定量测定方法,适用于肝脏脂肪含量的动态评估及疗效监测。
Objective:To investigate the pathological characteristics of patients with non-alcoholic fatty liver disease(NAFLD),their correlation with the magnetic resonance imaging estimated proton density fat fraction(MRI-PDFF)and liver function,and to explore the diagnostic value of MRI-PDFF in NAFLD.Methods:A total of 67 patients with NAFLD at the Department of Infectious Diseases,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were recruited from June 1,2021 to August 30,2023.Clinical characteristics were retrospectively analyzed based on different pathological fat content and non-alcoholic fatty liver disease activity score(NAS).Correlations among pathological fat content,NAS,MRI-PDFF,body mass index(BMI),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)were examined.A total of 33 individuals without hepatic steatosis confirmed by liver pathology were included as controls.The diagnostic value of MRI-PDFF for NAFLD was analyzed by receiver operating characteristic(ROC)curve.Results:Age,BMI,ALT,AST,MRI-PDFF,and NAS scores showed significant differences among different levels of pathological fat content.Similarly,BMI,ALT,AST,and MRI-PDFF differed significantly among different NAS scores.Liver MRI-PDFF was significantly related to pathological fat content(r=0.775,P<0.001),and moderately related to NAS(r=0.478,P<0.001)and BMI(r=0.402,P=0.001).Compared with the control group,the area under the curve(AUC)of MRI-PDFF for diagnosing NAFLD was 0.989,with a sensitivity of 0.94,specificity of 0.97,and an optimal cutoff value of 4.42%.Conclusion:MRIPDFF is a quantitative measurement that can accurately reflect liver fat content,suitable for dynamic assessment and therapeutic monitoring of hepatic steatosis.
作者
张帆
陆玮婷
史会连
陈沁磊
陈冉
乔飞
徐祥涛
ZHANG Fan;LU Weiting;SHI Huilian;CHEN Qinlei;CHEN Ran;QIAO Fei;XU Xiangtao(Department of Infectious Diseases,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China)
出处
《南京医科大学学报(自然科学版)》
北大核心
2026年第2期262-269,298,共9页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金(82374360)。
关键词
非酒精性脂肪性肝病
磁共振成像
质子密度脂肪分数
non-alcoholic fatty liver disease
magnetic resonance imaging
proton density fat fraction
