内素不连贯的运动扩散加权成像用于排除肝硬化中高风险食道静脉瘤
Jie Zhu1, Xiaoqing Zhang2, Zhuoya Yi1
1Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Abdominal radiology (New York)
|June 7, 2025
概括
在肝硬化患者中,用Intravoxel不连贯运动扩散权重成像 (IVIM) 可以帮助排除高风险食道静脉瘤 (HREVs). 脏微循环参数显示出避免不必要的内镜手术的可能性.
科学领域:
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
- 医疗成像医学成像
背景情况:
- 食道静脉 (EVs) 是肝硬化的一个常见并发症.
- 高危食道静脉瘤 (HREVs) 需要内镜查以防止出血.
- 非侵入性测试 (NITs) 的目的是减少对侵袭性手术的需要,如食道胃管透镜 (EGD).
研究的目的:
- 为了评估肝脏和脏Intravoxel不连贯运动扩散权重成像 (IVIM) 在识别高风险食道变节 (HREVs) 的有效性.
- 将IVIM成像的诊断性能与HREVs的现有非侵入性测试 (NIT) 进行比较.
- 评估IVIM参数的潜力,以减少肝硬化患者中不必要的EGDs的数量.
主要方法:
- 对244名经过EGD和腹部IVIM成像的肝硬化患者的回顾性分析.
- 后勤回归用于识别HREVs的预测因素.
- 使用AUROC曲线评估的诊断性能;为95%的灵敏度确定了切断值.
- 在IVIM和NIT之间比较EGD节约率;对NPV的敏感性分析.
主要成果:
- 在54.1%的患者中存在HREV.
- 脏参数f_S,D*_S和肝脏参数D*_L独立预测了HREVs.
- f_S (AUROC:0.90) 的表现明显优于其他NIT;D*_S (AUROC:0.74) 和D*_L (AUROC:0.73) 的表现类似.
- f_S (截止值≤16.1%) 实现了27.0%的EGD节省率,其中<5%的HREV错过,并且具有很好的重复性.
结论:
- 脏微循环 perfusion 参数,特别是 f_S 和 D*_S,是有效的非侵入性标志物,用于排除 HREVs.
- 在肝硬化患者中,IVIM成像,特别是脏参数,可以帮助避免不必要的EGD.
- 这种成像技术为HREVs查提供了一个有希望的替代方案.
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