| Purpose: To assess the feasibility of magnetic resonance(MR) susceptibilityweighted imaging(SWI) as a tool to evaluate iron deposition in patients with chronic liver disease utilizing signal intensity measurements in magnitude image, to find a noninvasive and simple method to assess for evaluation of liver fibrosis in patients with chronic liver disease.Material and Method: 77 cases hepatitis patients(including hepatitis B virus and hepatitis C virus hepatitis, viral hepatitis, alcohol hepatitis, mixed hepatitis), 62 cases liver cirrhosis patients(including the hepatitis B virus cirrhosis, HCV cirrhosis of the liver, alcohol liver cirrhosis, mixed cirrhosis of the liver) who diagnosed as chronic liver disease(CLD) were enrolled in the study, the clinical data collection, and 81 healthy volunteers were examined with MRI. There are 150 male and 70 female among patients, with age range from 19 to 82 years old. Laboratory data including aspartic acid aminotransferase aspartate transaminase, glutamic pyruvic transaminase, gamma glutamyl transpeptidase, alkaline phosphatase and total bilirubin.All patients with CLD and volunteers underwentroutine MRIand SWI sequence scan by using Siemens 3.0T MRI. The liver to muscle SI signal ratio and laboratory indexes were compared among healthy control group, hepatitis group and cirrhosis group by using single factor analysis of variance. Using multiple linear regression, Pearson correlation analysis and independent samples t test to analyze the relationship between iron deposition, fat deposition, inflammatory activity, age, gender and chronic liver disease, patients with different degrees of fibrosis.Result:Laboratory test results amongnormal volunteer group, hepatitis group and liver cirrhosis group only AST, TBIL groups differences were statistically significant(P<0.05), but ALT, GGT, ALP three groups were not statistically significant. Groups of volunteers, hepatitis group and cirrhosis group liver to muscle signal intensity ratio(LMR) were 0.78±0.02、0.69±0.03、0.59±0.02, accompanying with hepatitis, liver cirrhosis chronic progression, the LMR value of magnitude image decreased gradually, the value of magnitude image signal intensity of the normal volunteer group、the hepatitis group and liver cirrhosis group have statistically significantly difference(P<0.05).LMR values of male and female groups were 0.65±0.02、0.79±0.03, the two groups of LMR values were statistically significant(P<0.05). LMR decreased in parallel with increasing of GGT、TBIL、age(r=-0.188,-0.192,-0.149, P<0.05), did not correlate with AST, ALT, ALP(r=-0.094 and 0.060,-0.072. P<0.05). LMR decreased in parallel withiron deposition(r=-0.527, P < 0.01), did not correlate withthe degree of fibrosis and inflammation, age, fat deposition(r=-0.065, 0.102, 0.535, 0.271, P > 0.05). In multiple regression analysis, iron load independently influenced magnitude image measurements(P<0.05). LMR performed well in diagnosis CLD, with an area under the receiver operating characteristic curve of 0.748. Conclusion: Magnetic resonance SWI magnitude image could be used to analysis and assess the patients with chronic liver disease preliminary, reflect the iron deposition in the liver of chronic liver disease patients indirectly, but whether it could be used to assess the degree of liver fibrosis in patients with chronic liver disease is not definitely, and it has a certain application value in clinical diagnosis, evaluating treatment efficacy and follow-up process. Age and gender can affect the effects of chronic liver disease imageology manifestations, the relationship between various factors and chronic liver disease progression remains to be discussed, so SWI in patients with chronic liver diseases display also need to further research and discussion. Its clinical application still need further sequence improvement and parameters optimization. |
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