Abstract：
OBJECTIVE: There is an unmet clinical need for non-invasive imaging biomarkers that could replace liver biopsy in the management of patients with autoimmune hepatitis (AIH). In this study, we sought to evaluate the diagnostic accuracy of a simple uncorrected, non-contrast T1 mapping for detecting fibrosis and inflammation in AIH patients using histopathology as a reference standard.
METHODS: Over 3 years, 33 patients with AIH were prospectively studied using a multiparametric liver MRI protocol which included T1 mapping. Biopsies were performed up to 3 months before imaging, and a standardized histopathological score for fibrosis (F0-F4) and inflammatory activity (PPA0-4) was used as a reference. Statistical analysis included independent t test, Mann-Whitney U-test, and ROC (receiver operating characteristic) analysis.
RESULTS: T1 mapping values were significantly higher in patients with advanced fibrosis (F0-2 vs. F3-4; p < 0.015), significant fibrosis (F0-1 vs. F2-4; p < 0.005), and significant inflammatory activity (PPA 0-1 vs. PPA 2-4 p = 0.048). Moreover, the technique demonstrated a good diagnostic performance in detecting significant (AUC 0.856) and advanced fibrosis (AUC 0.835), as well as significant inflammatory activity (AUC 0.763).
CONCLUSIONS: A rapid, simple, uncorrected, non-contrast T1 mapping sequence showed satisfactory diagnostic performance in comparison with histopathology for detecting significant tissue inflammation and fibrosis in AIH patients, being a potential non-invasive imaging biomarker for monitoring disease activity in such individuals.
METHODS: Over 3 years, 33 patients with AIH were prospectively studied using a multiparametric liver MRI protocol which included T1 mapping. Biopsies were performed up to 3 months before imaging, and a standardized histopathological score for fibrosis (F0-F4) and inflammatory activity (PPA0-4) was used as a reference. Statistical analysis included independent t test, Mann-Whitney U-test, and ROC (receiver operating characteristic) analysis.
RESULTS: T1 mapping values were significantly higher in patients with advanced fibrosis (F0-2 vs. F3-4; p < 0.015), significant fibrosis (F0-1 vs. F2-4; p < 0.005), and significant inflammatory activity (PPA 0-1 vs. PPA 2-4 p = 0.048). Moreover, the technique demonstrated a good diagnostic performance in detecting significant (AUC 0.856) and advanced fibrosis (AUC 0.835), as well as significant inflammatory activity (AUC 0.763).
CONCLUSIONS: A rapid, simple, uncorrected, non-contrast T1 mapping sequence showed satisfactory diagnostic performance in comparison with histopathology for detecting significant tissue inflammation and fibrosis in AIH patients, being a potential non-invasive imaging biomarker for monitoring disease activity in such individuals.
摘要：
目的：在自身免疫性肝炎（AIH）患者的治疗中，对非侵入性成像生物标志物的临床需求尚未满足。在这项研究中,我们试图评估一个简单的未校正的诊断准确性，使用组织病理学作为参考标准，用于检测AIH患者的纤维化和炎症的非对比T1图。
方法：超过3年，33例AIH患者使用多参数肝脏MRI方案进行了前瞻性研究，其中包括T1映射。在成像前3个月进行活检，并以纤维化(F0-F4)和炎症活性(PPA0-4)的标准化组织病理学评分作为参考。统计学分析包括独立t检验,Mann-WhitneyU-test,和ROC(接收器工作特性)分析。
结果：晚期纤维化患者的T1映射值明显更高（F0-2vs.F3-4；p<0.015)，显著纤维化(F0-1vs.F2-4；p<0.005)，和显著的炎症活动(PPA0-1vs.PPA2-4p=0.048)。此外，该技术在检测显着（AUC0.856）和晚期纤维化（AUC0.835）方面表现出良好的诊断性能，以及显著的炎症活性（AUC0.763）。
结论：快速，简单,未更正,与组织病理学相比，非对比T1定位序列在AIH患者中检测到明显的组织炎症和纤维化方面显示出令人满意的诊断性能，作为用于监测此类个体中的疾病活动的潜在的非侵入性成像生物标志物。
方法：超过3年，33例AIH患者使用多参数肝脏MRI方案进行了前瞻性研究，其中包括T1映射。在成像前3个月进行活检，并以纤维化(F0-F4)和炎症活性(PPA0-4)的标准化组织病理学评分作为参考。统计学分析包括独立t检验,Mann-WhitneyU-test,和ROC(接收器工作特性)分析。
结果：晚期纤维化患者的T1映射值明显更高（F0-2vs.F3-4；p<0.015)，显著纤维化(F0-1vs.F2-4；p<0.005)，和显著的炎症活动(PPA0-1vs.PPA2-4p=0.048)。此外，该技术在检测显着（AUC0.856）和晚期纤维化（AUC0.835）方面表现出良好的诊断性能，以及显著的炎症活性（AUC0.763）。
结论：快速，简单,未更正,与组织病理学相比，非对比T1定位序列在AIH患者中检测到明显的组织炎症和纤维化方面显示出令人满意的诊断性能，作为用于监测此类个体中的疾病活动的潜在的非侵入性成像生物标志物。
