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• Clinical Article •
Evaluation of liver function and prediction of first decompensation event in patients with chronic hepatitis B by MRI functional liver imaging score and spontaneous portosystemic shunt
ZOU Jie  JIANG Yanli  FAN Fengxian  YANG Pin  YANG Wenxia  LI Darui  LIU Yang  ZHANG Jing 

Cite this article as: ZOU J, JIANG Y L, FAN F X, et al. Evaluation of liver function and prediction of first decompensation event in patients with chronic hepatitis B by MRI functional liver imaging score and spontaneous portosystemic shunt[J]. Chin J Magn Reson Imaging, 2025, 16(7): 30-38. DOI:10.12015/issn.1674-8034.2025.07.005.


[Abstract] Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI functional liver imaging score (FLIS) and spontaneous portal shunt (SPSS) on the liver function assessment in patients with chronic hepatitis B (CHB) and to construct a prediction model for the first decompensation event in CHB patients.Materials and methods A retrospective analysis was conducted on clinical and MRI data from 268 CHB patients who underwent Gd-EOB-DTPA-enhanced MRI at the Second Hospital of Lanzhou University between October 2019 and October 2021. The cohort included 192 males and 76 females, aged 21 to 77 years (mean ± SD: 48.5 ± 9.4). All patients had complete clinical laboratory test results within one week before or after the MRI examination. Patients were stratified into four groups based on the Fibrosis-4 (FIB-4) index and Child-Pugh (CP) classification: prehepatic cirrhosis chronic liver disease (CLD), early cirrhosis Child-Pugh A (CP A), mid-stage cirrhosis Child-Pugh B (CP B), and late cirrhosis Child-Pugh C (CP C). Comparison of clinical laboratory indicators and imaging parameters [FLIS, SPSS, spleen craniocaudal diameter (SCCD), portal vein width, splenic vein width] across groups using Friedman tests, chi-square tests and ANOVA for correlation analysis. Interobserver consistency of FLIS and its three components assessed via Kappa analysis. Diagnostic performance of imaging parameters for group differentiation evaluated using receiver operating characteristic (ROC) curves. Cox regression analysis of laboratory and imaging parameters with intergroup differences to predict the first decompensation event in CHB patients.Results (1) FLIS and its three parameters were moderately to strongly correlated with clinical groups (r = -0.464 to -0.671, P < 0.001). (2) Interobserver agreement for FLIS and its components was excellent (consistency coefficients: 0.931 to 1.000, P < 0.001). (3) SCCD was the optimal parameter for distinguishing CLD from CP A (AUC: 0.873, 95% CI: 0.769 to 0.904). The FLIS cutoff value of ≥ 5 best differentiated CLD/CP A from CP B/CP C (AUC: 0.839, 95% CI: 0.790 to 0.889), while FLIS ≥ 4 optimally separated CP B from CP C (AUC: 0.872, 95% CI: 0.820 to 0.924). (4) FLIS was not an independent predictor of first decompensation in CHB patients (log-rank of survival analysis, P = 0.203). Univariate analysis identified SPSS [hazard ratio (HR): 4.49] and SCCD ≥ 13.4 cm (HR: 4.81) as significant predictors (P < 0.05). The combination of SPSS (dichotomized) and SCCD provided superior predictive value for decompensation (AUC: 0.708, 95% CI: 0.631 to 0.785).Conclusions FLIS demonstrates optimal diagnostic performance for liver function grading in CHB patients. For predicting the first decompensation event in CHB patients, SPSS and SCCD exhibit significant predictive value.
[Keywords] chronic hepatitis B；hepatitis B virus decompensated cirrhosis；magnetic resonance imaging；gadolinium ethoxybenzyl diethylene triaminepentaacetic acid；functional liver imaging score

ZOU Jie1, 2, 3   JIANG Yanli1, 2, 3   FAN Fengxian1, 3   YANG Pin1, 3   YANG Wenxia1, 2   LI Darui1, 2   LIU Yang1, 2   ZHANG Jing1, 3*  

1 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2025-02-06
Accepted  2025-06-05
DOI: 10.12015/issn.1674-8034.2025.07.005
Cite this article as: ZOU J, JIANG Y L, FAN F X, et al. Evaluation of liver function and prediction of first decompensation event in patients with chronic hepatitis B by MRI functional liver imaging score and spontaneous portosystemic shunt[J]. Chin J Magn Reson Imaging, 2025, 16(7): 30-38. DOI:10.12015/issn.1674-8034.2025.07.005.

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