Purpose To evaluate the performance of diffusion-weighted imaging(DWI) and variable flip angle(VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis. Materials and Methods This...Purpose To evaluate the performance of diffusion-weighted imaging(DWI) and variable flip angle(VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis. Materials and Methods This prospective study was approved by the institution's committee on human research, and written informed consent was provided from the enrolled patients. We investigated five MRI parameters of DWI and VFA T1 mapping, collected from 11 patients who underwent serial ultrasound image-guided biopsy with follow-up MRI within 1.5 years after treatment for liver fibrosis/cirrhosis. For each patient, four consecutive MRI examinations were conducted, including baseline MRI before treatment and three follow-up MRI examinations after treatment at each 0.5-year interval. ADC values at four b values and T1 relaxation times were correlated to pathology-confirmed liver fibrosis stages, which were subsequently divided into two groups, stages F2–3 and F4. The receiver operating characteristic(ROC) analysis and repeated measurement analysis of variance were used for statistical analysis. Results Among these ADC parameters, ADC value(b = 500 s/mm^2) was the most consistent in differentiating between stage F2–3 and F4 liver fibrosis. Repeated measurement analysis showed that the intra-group and inter-group differences were 0.447 and 0.024, respectively. T1 relaxation time could not consistently differentiate between the F2–3 and F4 groups; however, it was repeatable, and the intra-group and inter-group differences were 0.410 and 0.042, respectively. Conclusion MRI-ADC value at a b value of 500 s/mm^2 can be a promising biomarker for differentiating stages F2–3 and F4 liver fibrosis. A combination of this biomarker with repeatable T1 relaxation time may function as a non-invasive tool for follow-up liver fibrosis in patients who reject repeated image-guided biopsy.展开更多
This study aimed to review the trends of hepatitis C virus(HCV)treatment over the past decade and to analyze the effectiveness of sofosbuvir(SOF)–based direct-acting antiviral regimens in the heterogeneous population...This study aimed to review the trends of hepatitis C virus(HCV)treatment over the past decade and to analyze the effectiveness of sofosbuvir(SOF)–based direct-acting antiviral regimens in the heterogeneous population of patients with chronic hepatitis C(CHC)in clinical practice.This retrospective cohort study included CHC patients attending the Sir Run Run Shaw Hospital between January 1,2012,and December 31,2022.All of the 194 patients treatedwith SOF-based regimens completed 12weeks of treatment and were followed up for at least 12 weeks after completion of the therapy.Sustained virologic response(SVR)12 weeks after the end of treatment was the primary endpoint.A total of 194 patients treated with SOF-based regimens were included,among which 121,56,10 and 7 patients received SOF+velpatasvir±ribavirin,SOF+daclatasvir,SOF+ledipasvir or SOF+ribavirin,respectively.With 36.1%,HCV Genotype 1 predominated in CHC patients treated with SOF-based regimens,followed by Genotype 2a with 17.5%and Genotype 3 with 14.9%.Comorbidities among patients included hypertension(4.1%),diabetes(2.1%),depression(1.0%)and neoplastic disease(2.6%).All patients treated with SOF-based regimens achieved SVR.There was no association between SVR and factors such as HCV genotype,sex,age,presence of cirrhosis or previous treatment history.There were no reports of any serious adverse events in the study.This single-center retrospective study represented the latest 10-year treatment trends for HCV in real-world clinical practice and provided useful information on the excellent efficacy of SOF-based direct-acting antiviral regimens for treatment of CHC patients in Eastern China.展开更多
文摘Purpose To evaluate the performance of diffusion-weighted imaging(DWI) and variable flip angle(VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis. Materials and Methods This prospective study was approved by the institution's committee on human research, and written informed consent was provided from the enrolled patients. We investigated five MRI parameters of DWI and VFA T1 mapping, collected from 11 patients who underwent serial ultrasound image-guided biopsy with follow-up MRI within 1.5 years after treatment for liver fibrosis/cirrhosis. For each patient, four consecutive MRI examinations were conducted, including baseline MRI before treatment and three follow-up MRI examinations after treatment at each 0.5-year interval. ADC values at four b values and T1 relaxation times were correlated to pathology-confirmed liver fibrosis stages, which were subsequently divided into two groups, stages F2–3 and F4. The receiver operating characteristic(ROC) analysis and repeated measurement analysis of variance were used for statistical analysis. Results Among these ADC parameters, ADC value(b = 500 s/mm^2) was the most consistent in differentiating between stage F2–3 and F4 liver fibrosis. Repeated measurement analysis showed that the intra-group and inter-group differences were 0.447 and 0.024, respectively. T1 relaxation time could not consistently differentiate between the F2–3 and F4 groups; however, it was repeatable, and the intra-group and inter-group differences were 0.410 and 0.042, respectively. Conclusion MRI-ADC value at a b value of 500 s/mm^2 can be a promising biomarker for differentiating stages F2–3 and F4 liver fibrosis. A combination of this biomarker with repeatable T1 relaxation time may function as a non-invasive tool for follow-up liver fibrosis in patients who reject repeated image-guided biopsy.
基金supported by the Natural Science Foundation of Zhejiang Province(no.LY21H030011)ZhejiangMedical Health Science and Technology Program—Young Innovative Support Program(no.2022RC196).
文摘This study aimed to review the trends of hepatitis C virus(HCV)treatment over the past decade and to analyze the effectiveness of sofosbuvir(SOF)–based direct-acting antiviral regimens in the heterogeneous population of patients with chronic hepatitis C(CHC)in clinical practice.This retrospective cohort study included CHC patients attending the Sir Run Run Shaw Hospital between January 1,2012,and December 31,2022.All of the 194 patients treatedwith SOF-based regimens completed 12weeks of treatment and were followed up for at least 12 weeks after completion of the therapy.Sustained virologic response(SVR)12 weeks after the end of treatment was the primary endpoint.A total of 194 patients treated with SOF-based regimens were included,among which 121,56,10 and 7 patients received SOF+velpatasvir±ribavirin,SOF+daclatasvir,SOF+ledipasvir or SOF+ribavirin,respectively.With 36.1%,HCV Genotype 1 predominated in CHC patients treated with SOF-based regimens,followed by Genotype 2a with 17.5%and Genotype 3 with 14.9%.Comorbidities among patients included hypertension(4.1%),diabetes(2.1%),depression(1.0%)and neoplastic disease(2.6%).All patients treated with SOF-based regimens achieved SVR.There was no association between SVR and factors such as HCV genotype,sex,age,presence of cirrhosis or previous treatment history.There were no reports of any serious adverse events in the study.This single-center retrospective study represented the latest 10-year treatment trends for HCV in real-world clinical practice and provided useful information on the excellent efficacy of SOF-based direct-acting antiviral regimens for treatment of CHC patients in Eastern China.
