中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

磁共振质子密度脂肪分数(MRI-PDFF)在肝脂肪定量中的应用

杨晨 余上海 徐飞鹏 张华

引用本文:
Citation:

磁共振质子密度脂肪分数(MRI-PDFF)在肝脂肪定量中的应用

DOI: 10.12449/JCH240327
基金项目: 

2019年度上海市科学技术委员会“科技创新行动计划”临床医学领域科技支撑项目 (19401972700)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:张华、杨晨负责课题设计,撰写论文;杨晨、余上海、徐飞鹏参与查阅文献,撰写论文初稿,修改论文;张华负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    张华, lnutcmzh@126.com (ORCID: 0000-0001-5926-0999)

Application of magnetic resonance imaging-proton density fat fraction in liver fat quantification

Research funding: 

Shanghai Municipal Science and Technology Commission 2019 “Science and Technology Innovation Action Plan” (Clinical Medicine) (19401972700)

More Information
    Corresponding author: ZHANG Hua, lnutcmzh@126.com (ORCID: 0000-0001-5926-0999)
  • 摘要: 不同病因的慢性肝病均可出现肝脂肪变性。引起肝脂肪性病变的主要诱因包括慢性病毒性肝炎、胆汁淤积性肝病、酒精和非酒精性脂肪性肝病等。肝脂肪变性初期表现为单纯性脂肪性肝病,继而出现脂肪性肝炎、肝纤维化、肝硬化,甚至肝细胞癌。随着医学影像技术的发展,磁共振质子密度脂肪分数(MRI-PDFF)已在临床广泛应用于脂肪性肝病(FLD)的诊断。MRI-PDFF因具有精确性高及可重复性好的优点,逐步成为FLD无创诊断的“金标准”。本文对MRI-PDFF在肝脂肪定量中的临床应用及研究进展进行综述。

     

  • [1] POWELL EE, JONSSON JR, CLOUSTON AD. Steatosis: co-factor in other liver diseases[J]. Hepatology, 2005, 42( 1): 5- 13. DOI: 10.1002/hep.20750.
    [2] TAMAKI N, AJMERA V, LOOMBA R. Non-invasive methods for imaging hepatic steatosis and their clinical importance in NAFLD[J]. Nat Rev Endocrinol, 2022, 18( 1): 55- 66. DOI: 10.1038/s41574-021-00584-0.
    [3] RATZIU V, CHARLOTTE F, HEURTIER A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease[J]. Gastroenterology, 2005, 128( 7): 1898- 1906. DOI: 10.1053/j.gastro.2005.03.084.
    [4] BOHTE AE, van WERVEN JR, BIPAT S, et al. The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis[J]. Eur Radiol, 2011, 21( 1): 87- 97. DOI: 10.1007/s00330-010-1905-5.
    [5] JOHNSTON RJ, STAMM ER, LEWIN JM, et al. Diagnosis of fatty infiltration of the liver on contrast enhanced CT: Limitations of liver-minus-spleen attenuation difference measurements[J]. Abdom Imaging, 1998, 23( 4): 409- 415. DOI: 10.1007/s002619900370.
    [6] FISCHER MA, GNANNT R, RAPTIS D, et al. Quantification of liver fat in the presence of iron and iodine: an ex-vivo dual-energy CT study[J]. Invest Radiol, 2011, 46( 6): 351- 358. DOI: 10.1097/RLI.0b013e31820e1486.
    [7] CHO YS, LIM S, KIM Y, et al. Abdominal wall thickness affects liver stiffness measurements by 2-D shear wave elastography in patients with chronic liver disease[J]. Ultrasound Med Biol, 2019, 45( 10): 2697- 2703. DOI: 10.1016/j.ultrasmedbio.2019.06.415.
    [8] MU R, LU LG. Advances in the application of magnetic resonance imaging in hepatic fat quantification in patients with nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2020, 36( 6): 1366- 1369. DOI: 10.3969/j.issn.1001-5256.2020.06.038.

    穆容, 陆伦根. 磁共振成像技术在非酒精性脂肪性肝病肝脂肪定量中的应用[J]. 临床肝胆病杂志, 2020, 36( 6): 1366- 1369. DOI: 10.3969/j.issn.1001-5256.2020.06.038.
    [9] European Association for the Study of the Liver(EASL), European Association for the Study of Diabetes(EASD), European Association for the Study of Obesity(EASO). EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease[J]. Obes Facts, 2016, 9( 2): 65- 90. DOI: 10.1159/000443344.
    [10] STERN C, CASTERA L. Non-invasive diagnosis of hepatic steatosis[J]. Hepatol Int, 2017, 11( 1): 70- 78. DOI: 10.1007/s12072-016-9772-z.
    [11] RUNGE JH, SMITS LP, VERHEIJ J, et al. MR spectroscopy-derived proton density fat fraction is superior to controlled attenuation parameter for detecting and grading hepatic steatosis[J]. Radiology, 2017: 162931. DOI: 10. 1148/radiol. 2017162931.
    [12] GUO D, YANG C. Progress in MRI research on fatty liver[J]. Med J West China, 2017, 29( 4): 419- 422.

    郭达, 杨陈. 脂肪肝的MRI研究进展[J]. 西部医学, 2017, 29( 4): 419- 422.
    [13] CAUSSY C, REEDER SB, SIRLIN CB, et al. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH trials[J]. Hepatology, 2018, 68( 2): 763- 772. DOI: 10.1002/hep.29797.
    [14] BANNAS P, KRAMER H, HERNANDO D, et al. Quantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human livers[J]. Hepatology, 2015, 62( 5): 1444- 1455. DOI: 10.1002/hep.28012.
    [15] REEDER SB, HU HH, SIRLIN CB. Proton density fat-fraction: a standardized MR-based biomarker of tissue fat concentration[J]. J Magn Reson Imaging, 2012, 36( 5): 1011- 1014. DOI: 10.1002/jmri.23741.
    [16] MAMIDIPALLI A, FOWLER KJ, HAMILTON G, et al. Prospective comparison of longitudinal change in hepatic proton density fat fraction(PDFF) estimated by magnitude-based MRI(MRI-M) and complex-based MRI(MRI-C)[J]. Eur Radiol, 2020, 30( 9): 5120- 5129. DOI: 10.1007/s00330-020-06858-x.
    [17] HERNANDO D, SHARMA SD, ALIYARI GHASABEH M, et al. Multisite, multivendor validation of the accuracy and reproducibility of proton-density fat-fraction quantification at 1.5T and 3T using a fat-water phantom[J]. Magn Reson Med, 2017, 77( 4): 1516- 1524. DOI: 10.1002/mrm.26228.
    [18] YOSHIZAWA E, YAMADA A. MRI-derived proton density fat fraction[J]. J Med Ultrason(2001), 2021, 48( 4): 497- 506. DOI: 10.1007/s10396-021-01135-w.
    [19] VU KN, GILBERT G, CHALUT M, et al. MRI-determined liver proton density fat fraction, with MRS validation: Comparison of regions of interest sampling methods in patients with type 2 diabetes[J]. J Magn Reson Imaging, 2016, 43( 5): 1090- 1099. DOI: 10.1002/jmri.25083.
    [20] SATKUNASINGHAM J, HOSSEINI NIK H, Fischer S, et al. Can negligible hepatic steatosis determined by MRI-proton density fat fraction obviate the need for liver biopsy in potential liver donors?[J]. Liver Transpl, 2018, 24( 4): 470- 477. DOI: 10. 1002/lt. 24965.
    [21] CAMPO CA, HERNANDO D, SCHUBERT T, et al. Standardized approach for roi-based measurements of proton density fat fraction and R2* in the liver[J]. AJR Am J Roentgenol, 2017, 209( 3): 592- 603. DOI: 10.2214/AJR.17.17812.
    [22] LU WT, SHI HL, CHEN QL, et al. Distribution characteristics of MRI-PDFF in patients with metabolic related fatty liver disease[J/CD]. Chin J Clinicians: Electronic Edition, 2021, 15( 7): 503- 508. DOI: 10.3877/cma.j.issn.1674-0785.2021.07.005.

    陆玮婷, 史会连, 陈沁磊, 等. 代谢相关脂肪性肝病患者MRI-PDFF分布特点[J/CD]. 中华临床医师杂志: 电子版, 2021, 15( 7): 503- 508. DOI: 10.3877/cma.j.issn.1674-0785.2021.07.005.
    [23] PERMUTT Z, LE TA, PETERSON MR, et al. Correlation between liver histology and novel magnetic resonance imaging in adult patients with non-alcoholic fatty liver disease- MRI accurately quantifies hepatic steatosis in NAFLD[J]. Aliment Pharmacol Ther, 2012, 36( 1): 22- 29. DOI: 10.1111/j.1365-2036.2012.05121.x.
    [24] SHAO CX, YE J, DONG Z, et al. Steatosis grading consistency between controlled attenuation parameter and MRI-PDFF in monitoring metabolic associated fatty liver disease[J]. Ther Adv Chronic Dis, 2021, 12: 20406223211033119. DOI: 10.1177/20406223211033119.
    [25] TAMAKI N, MUNAGANURU N, JUNG J, et al. Clinical utility of 30% relative decline in MRI-PDFF in predicting fibrosis regression in non-alcoholic fatty liver disease[J]. Gut, 2022, 71( 5): 983- 990. DOI: 10.1136/gutjnl-2021-324264.
    [26] HARRISON SA, BASHIR MR, GUY CD, et al. Resmetirom(MGL-3196) for the treatment of non-alcoholic steatohepatitis: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial[J]. Lancet, 2019, 394( 10213): 2012- 2024. DOI: 10.1016/S0140-6736(19)32517-6.
    [27] PARK CC, NGUYEN P, HERNANDEZ C, et al. Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease[J]. Gastroenterology, 2017, 152( 3): 598- 607. e 2. DOI: 10.1053/j.gastro.2016.10.026.
    [28] LEE SJ, KIM SU. Noninvasive monitoring of hepatic steatosis: controlled attenuation parameter and magnetic resonance imaging-proton density fat fraction in patients with nonalcoholic fatty liver disease[J]. Expert Rev Gastroenterol Hepatol, 2019, 13( 6): 523- 530. DOI: 10.1080/17474124.2019.1608820.
    [29] JAYAKUMAR S, MIDDLETON MS, LAWITZ EJ, et al. Longitudinal correlations between MRE, MRI-PDFF, and liver histology in patients with non-alcoholic steatohepatitis: Analysis of data from a phase II trial of selonsertib[J]. J Hepatol, 2019, 70( 1): 133- 141. DOI: 10.1016/j.jhep.2018.09.024.
    [30] KIM HJ, CHO HJ, KIM B, et al. Accuracy and precision of proton density fat fraction measurement across field strengths and scan intervals: A phantom and human study[J]. J Magn Reson Imaging, 2019, 50( 1): 305- 314. DOI: 10.1002/jmri.26575.
    [31] QI Q, WEINSTOCK AK, CHUPETLOVSK AK, et al. Magnetic resonance imaging-derived proton density fat fraction(MRI-PDFF) is a viable alternative to liver biopsy for steatosis quantification in living liver donor transplantation[J]. Clin Transplant, 2021, 35( 7): e14339. DOI: 10.1111/ctr.14339.
    [32] REN H, YANG ZH. Progress in the application of MRI diagnostic techniques related to non-alcoholic fatty liver disease[J]. Radiol Pract, 2020, 35( 7): 928- 932. DOI: 10.13609/j.cnki.1000-0313.2020.07.019.

    任浩, 杨正汉. 非酒精性脂肪肝病相关MRI诊断技术的应用进展[J]. 放射学实践, 2020, 35( 7): 928- 932. DOI: 10.13609/j.cnki.1000-0313.2020.07.019.
    [33] MARTÍ-AGUADO D, ALBERICH-BAYARRI Á, MARTÍN-RODRÍGUEZ JL, et al. Differences in multi-echo chemical shift encoded MRI proton density fat fraction estimation based on multifrequency fat peaks selection in non-alcoholic fatty liver disease patients[J]. Clin Radiol, 2020, 75( 11): 880. e5- 880. e 12. DOI: 10.1016/j.crad.2020.07.031.
    [34] KIM JW, LEE CH, YANG Z, et al. The spectrum of magnetic resonance imaging proton density fat fraction(MRI-PDFF), magnetic resonance spectroscopy(MRS), and two different histopathologic methods(artificial intelligence vs. pathologist) in quantifying hepatic steatosis[J]. Quant Imaging Med Surg, 2022, 12( 11): 5251- 5262. DOI: 10.21037/qims-22-393.
    [35] IDILMAN IS, KESKIN O, CELIK A, et al. A comparison of liver fat content as determined by magnetic resonance imaging-proton density fat fraction and MRS versus liver histology in non-alcoholic fatty liver disease[J]. Acta Radiol, 2016, 57( 3): 271- 278. DOI: 10.1177/0284185115580488.
    [36] YOKOO T, SERAI S D, PIRASTEH A, et al. Linearity, bias, and precision of hepatic proton density fat fraction measurements by using mr imaging: a meta-analysis[J]. Radiology, 2018, 286( 2): 486- 498. DOI: 10. 1148/radiol. 2017170550.
    [37] CHEN G, JIANG J, WANG X, et al. Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF-MRI[J]. Magn Reson Med, 2021, 85( 5): 2805- 2814. DOI: 10.1002/mrm.28592.
    [38] GU J, LIU S, DU S, et al. Diagnostic value of MRI-PDFF for hepatic steatosis in patients with non-alcoholic fatty liver disease: a meta-analysis[J]. Eur Radiol, 2019, 29( 7): 3564- 3573. DOI: 10.1007/s00330-019-06072-4.
    [39] YANG YM, LIU YP, ZHOU DJ, et, al. The value of 3.0T MRI PDFF and IP-OP in quantitative evaluation of fatty liver[J]. J Jilin Univ(Med Edit), 2020, 46( 4): 875- 880. DOI: 10.13481/j.1671-587x.20200434.

    杨逸铭, 刘玉品, 周懂晶, 等. 3.0T MRI PDFF和IP-OP对脂肪肝定量评估的价值[J]. 吉林大学学报: 医学版, 2020, 46( 4): 875- 880. DOI: 10.13481/j.1671-587x.20200434.
    [40] STINE JG, MUNAGANURU N, BARNARD A, et al. Change in MRI-PDFF and histologic response in patients with nonalcoholic steatohepatitis: a systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2021, 19( 11): 2274- 2283. e 5. DOI: 10.1016/j.cgh.2020.08.061.
    [41] LU JN, LI YS, WEN Y, et al. Application value of liver/spleen CT value, controlled attenuation parameter,and magnetic resonance imagingproton density fat fraction in chronic hepatitis B patients with hepatic steatosis[J]. J Clin Hepatol, 2024, 40( 1): 46- 51. DOI: 10.12449/JCH240109.

    鲁景楠, 李岩松, 温雅, 等. 肝/脾CT值、CAP和MRI-PDFF在慢性乙型肝炎脂肪变性患者中的应用价值[J]. 临床肝胆病杂志, 2024, 40( 1): 46- 51. DOI: 10.12449/JCH240109.
    [42] YANG YM, LIU YP, HUANG LX, et al. Quantitative evaluation of liver fat content in patients with chronic hepatitis B using magnetic resonance proton density fat fraction and transient elastography[J]. J Clin Hepatol, 2021, 37( 12): 2793- 2797. DOI: 10.3969/j.issn.1001-5256.2021.12.013.

    杨逸铭, 刘玉品, 黄丽霞, 等. 磁共振质子密度脂肪分数和瞬时弹性成像对慢性乙型肝炎患者肝脂肪含量的定量评估价值[J]. 临床肝胆病杂志, 2021, 37( 12): 2793- 2797. DOI: 10.3969/j.issn.1001-5256.2021.12.013.
    [43] CHO Y, RHEE H, KIM YE, et al. Ezetimibe combination therapy with statin for non-alcoholic fatty liver disease: an open-label randomized controlled trial(ESSENTIAL study)[J]. BMC Med, 2022, 20( 1): 93. DOI: 10.1186/s12916-022-02288-2.
    [44] LU WT, LIU LN, SHI HL, et al. Clinical study on the treatment of 68 cases of non alcoholic fatty liver disease of liver depression and spleen deficiency type with“Jiuwei Qingzhi Cream”[J]. Jiangsu J Traditi Chin Med, 2022, 54( 7): 33- 36. DOI: 10.19844/j.cnki.1672-397X.

    陆玮婷, 刘丽娜, 史会连, 等.“九味清脂膏”治疗肝郁脾虚型非酒精性脂肪性肝病68例临床研究[J]. 江苏中医药, 2022, 54( 7): 33- 36. DOI: 10.19844/j.cnki.1672-397X.
    [45] ALKHOURI N, HERRING R, KABLER H, et al. Safety and efficacy of combination therapy with semaglutide, cilofexor and firsocostat in patients with non-alcoholic steatohepatitis: A randomised, open-label phase II trial[J]. J Hepatol, 2022, 77( 3): 607- 618. DOI: 10.1016/j.jhep.2022.04.003.
    [46] AN ZM, FENG Q. Magnetic resonance imaging-proton density fat fraction: A potential surrogate endpoint for nonalcoholic steatohepatitis clinical trials[J]. J Clin Hepatol, 2021, 37( 6): 1445- 1448. DOI: 10.3969/j.issn.1001-5256.2021.06.047.

    安梓铭, 冯琴. 磁共振质子密度脂肪分数——一种具有潜力的非酒精性脂肪性肝炎临床试验替代终点[J]. 临床肝胆病杂志, 2021, 37( 6): 1445- 1448. DOI: 10.3969/j.issn.1001-5256.2021.06.047.
  • 加载中
计量
  • 文章访问数:  102
  • HTML全文浏览量:  56
  • PDF下载量:  26
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-08-08
  • 录用日期:  2023-08-28
  • 出版日期:  2024-03-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回