慢性乙型肝炎纵向T1ρ定量：从纤维化分期到聚乙二醇化干扰素-α治疗反应跟踪

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-27 DOI:10.1016/j.ejrad.2025.112203

Xin-Gui Peng, Yufei Zhao, Zhi Qin, Yang Jiang, Jingyue Dai, Ying Cui

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引用次数: 0

摘要

原理和目的研究慢性乙型肝炎（CHB）进展阶段的肝组织改变，并利用T1ρ磁共振成像（MRI）监测聚乙二醇化干扰素-α (PEG-IFNα)治疗后的治疗变化。材料和方法本前瞻性研究纳入93例慢性乙型肝炎患者，按组织学严重程度分层：轻度44例，中度26例，重度23例。所有患者在基线时进行肝活检和T1ρ MRI，随后进行48周的PEG-IFNα治疗。36例患者治疗后完成T1ρ MRI。对照组23名健康志愿者接受了基线核磁共振扫描。比较各亚组间肝脏T1ρ松弛时间，并与组织病理学参数（炎症分级、纤维化分期）、血清生物标志物（丙氨酸转氨酶[ALT]、天冬氨酸转氨酶[AST]、总胆红素[TBIL]、直接胆红素[DBIL]、胆碱酯酶[CHE]）和无创指标（纤维化-4指数[FIB-4]）相关。统计分析包括Spearman相关和线性回归。结果轻度慢性乙型肝炎组T1ρ松弛时间（43.94±4.88 ms）明显高于健康对照组（39.05±3.07 ms）；P = 0.028)，中度进行性增高(48.21±5.78 ms；P = 0.022 vs轻度)和重度亚组(53.99±5.78 ms；P & lt;0.001 vs中度)。所有患者组均与对照组有显著差异(P <；0.001)。T1ρ松弛时间与组织病理进展呈强正相关(纤维化分期R2 = 0.77，炎症分级R2 = 0.50；P <；0.001)，与肝功能参数有中度相关性(ALT: R2 = 0.18；AST: R2 = 0.21)和合成标记（CHE: R2 = 0.24）。治疗后T1ρ值与基线相比显著降低（48.99±8.05 ms vs 43.57±7.20 ms, P = 0.014）。结论t1 ρ MRI为评估CHB患者肝脏疾病严重程度和监测治疗相关变化提供了一种有前途的无创工具。

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Longitudinal T1ρ quantification in chronic hepatitis B: from fibrosis staging to pegylated interferon-α therapeutic response tracking

Rationale and objectives

To investigate liver tissue alterations across chronic hepatitis B (CHB) progression stages and monitor therapeutic changes following pegylated interferon-α (PEG-IFNα) therapy using T₁ρ magnetic resonance imaging (MRI).

Materials and methods

This prospective study enrolled 93 CHB patients stratified by histological severity: 44 mild, 26 moderate, and 23 severe cases. All patients underwent liver biopsy and T₁ρ MRI at baseline, followed by 48 weeks of PEG-IFNα therapy. 36 patients completed post-treatment T₁ρ MRI. A control cohort of 23 healthy volunteers received baseline MRI scans. Hepatic T₁ρ relaxation times were compared across subgroups and correlated with histopathological parameters (inflammation grade, fibrosis stage), serum biomarkers (alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TBIL], direct bilirubin [DBIL], cholinesterase [CHE]), and non-invasive indices (fibrosis-4 index [FIB-4]). Statistical analyses included Spearman’s correlation and linear regression.

Results

The mild CHB group showed elevated T₁ρ relaxation time (43.94 ± 4.88 ms) versus healthy controls (39.05 ± 3.07 ms; P = 0.028), with progressive increases in moderate (48.21 ± 5.78 ms; P = 0.022 vs mild) and severe subgroups (53.99 ± 5.78 ms; P < 0.001 vs moderate). All patient groups differed significantly from controls (all P < 0.001). T₁ρ relaxation times exhibited strong positive correlations with histopathological progression (R² = 0.77 for fibrosis stage, R² = 0.50 for inflammation grade; both P < 0.001) and moderate correlations with liver function parameters (ALT: R² = 0.18; AST: R² = 0.21) and synthetic markers (CHE: R² = 0.24). Post-therapeutic T₁ρ values decreased significantly compared to baseline (48.99 ± 8.05 ms vs. 43.57 ± 7.20 ms, P = 0.014).

Conclusion

T₁ρ MRI provides a promising non-invasive tool for assessing liver disease severity and monitoring treatment-related changes in CHB patients.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.