目的 探讨3.0TMR弹性成像(MRE)评价健康志愿者及慢性肝病患者肝弹性值的可靠性及评估者测量结果的一致性.方法采用3.0 T MRE分析24名健康志愿者(无肝病组)及64例临床确诊的慢性肝病患者(肝病组,其中22例经肝脏穿刺活检证实)肝脏的弹性值.由2名评估者盲法测量肝弹性值,采用组内相关系数(ICC)评价评估者所测肝弹性值的一致性,采用Mann-Whitney U检验分析两组受试者肝弹性值的差异,采用Spearman检验分析病理纤维化分期与肝弹性值之间的相关性.结果2名评估者所测肝弹性值之间具有良好的一致性(ICC=0.99),无肝病组及肝病组受试者的肝弹性值分别为(2.35±0.34) kPa及(4.17±0.47) kPa,二者的差异有统计学意义(U=90.5,P＜0.01).22例行肝穿刺患者肝纤维化分期S0、S1、S2、S3和S4患者分别为3、3、5、5和6例,肝弹性值中位数分别为2.13、3.25、3.82、5.45和7.35 kPa,弹性值与纤维化分期之间具有强相关性(r=0.96,P＜0.01).结论 MRE是一种可靠的测量肝弹性值及评估肝纤维化分期的方法.%Objective To estimate reliability of magnetic resonance elastography (MRE) in measuring liver stiffness of volunteers and patients with chronic liver disease and to assess inter-rater consistency.Methods MRE was performed on a 3.0 T scanner in all subjects,including 24 volunteers (control group) and 64 patients with liver disease (chronic liver disease group).Liver stiffness was measured blindly by two raters.The pathological fibrosis score was applied as a standard reference for liver fibrosis in 22 patients.The intraclass correlation coefficient (ICC) was used to evaluate inter-rater reliability.The differences of liver stiffness between two groups were evaluated using non-parametric MannWhitney U test.Spearman analysis was used to analyze the correlation between fibrosis stages and liver stiffness.Results The intraclass correlation coefficient of liver stiffness was perfect (ICC =0.99,P ＜ 0.01)between two raters.There was significant difference of mean stiffness between control group and patient group (U =90.5,P ＜0.01) with(2.35 ±0.34) kPa and(4.17 ± 0.47) kPa,respectively.The correlation between fibrosis stage (3,3,5,5 and 6 patients in fibrosis stage S0,S1,S2,S3 and S4) and stiffness (2.13,3.25,3.82,5.45 and 7.35 kPa) was very strong (r =0.96,P ＜0.01).Conclusion MRE is a reliable and promising tool to measure liver stiffness and to assess liver fibrosis.
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