| 王秋实,刘辉,梁长虹,张明辉,林华欢,郑君惠,曾琼新.血液生化学与磁共振弥散加权成像在兔肝纤维化中的诊断价值比较及相关性分析[J].中国医学影像技术,2009,25(11):1961~1964 |
| 血液生化学与磁共振弥散加权成像在兔肝纤维化中的诊断价值比较及相关性分析 |
| Comparison and correlation between blood biochemistry and MR diffusion-weighted imaging in the diagnosis of liver fibrosis in rabbits |
| 投稿时间：2009-05-08 修订日期：2009-07-05 |
| DOI： |
| 中文关键词: 肝硬化 磁共振成像 ROC曲线 |
| 英文关键词:Liver cirrhosis Magnetic resonance imaging ROC curve |
| 基金项目:广东省医学科研基金(A2009026)。 |
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| 中文摘要: |
| 目的 探讨血清肝纤维化标志物和磁共振弥散加权成像(MR-DWI)在诊断兔肝纤维化中的价值及相互关系。 方法 对以CCl4 诱导产生的肝纤维化模型兔和对照组兔行血清肝纤维化标志物和MR-DWI检查。血清学指标包括透明质酸(HA)、III型前胶原(PCIII)、IV型胶原(C-IV)和层黏连蛋白(LN),MR-DWI参数选择b=600 s/mm2时的DWI图像信号强度(SI)、表观弥散系数(ADC)和指数表观弥散系数(EADC)值。以病理学肝纤维化分期为标准,比较不同程度肝纤维化时血清肝纤维化标志物和MR-DWI变化。应用受试者工作特性曲线(ROC)评价两者各诊断指标在肝纤维化中的诊断效能,同时行血清学和MR-DWI指标间的相关性分析。结果 随纤维化分期进展,血清HA值依次升高,MR-DWI中SI、EADC值依次升高,ADC值依次降低(P<0.05)。血清HA值及MR-DWI中SI、ADC、EADC值可将S0与S3、S0与S4以及S1与S4期纤维化进行区分,但均无法区分S0与S1期、S3与S4期纤维化之间的差异。ROC曲线下面积血清HA>C-IV>LN>PCIII,MR-DWI中SI>EADC=ADC;所有指标的曲线下面积、灵敏度和特异度均在0.5~0.9之间。HA与SI存在显著正相关(P<0.01),ADC、EADC与各血清肝纤维化标志物间无相关性。结论 血清肝纤维化标志物和MR-DWI在诊断肝纤维化中能力相仿,但无灵敏度和特异度俱佳的诊断指标。HA与SI值之间的相关关系共同反映活动性肝纤维化的特点。 |
| 英文摘要: |
| Objective To investigate the value of serum fibrosis markers and diffusion-weighted MR imaging (MR-DWI) and the relationship between them in the diagnosis of liver fibrosis in rabbits. Methods Rabbits with liver fibrosis induced with CCl4 and controls were sampled blood preparation and performed MR-DWI. Serum fibrosis markers included hyaluronic acid (HA), procollagen type III (PCIII), type IV collagen (C-IV) and laminin (LN). Signal intensity (SI), apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (EADC) obtained when b value was 600 s/mm2 were included as MR-DWI parameters. The mean value of each index of serology and MR-DWI were compared among different stages of liver fibrosis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of all indices. The relationship between serum fibrosis markers and MR-DWI parameters were analyzed. Results The serum level of HA and the mean value of SI, EADC increased while the value of ADC decreased gradually with the progression of liver fibrosis (P<0.05). Moreover, the severity of liver fibrosis between S0 and S3, S0 and S4, S1 and S4 could be distinguished according to HA and SI, ADC, EADC. Area under the curve (AUC) of serum fibrosis markers and MR-DWI parameters in analysis of ROC curves were in the order of HA>C-IV>LN>PCIII and SI>EADC=ADC, respectively. Analysis of ROC curves showed that AUC, sensitivity and specificity of all indices were between 0.5 and 0.9. There was positive correlation between HA and SI (P<0.01). No relationship was found between ADC, EADC and serum indices. Conclusion Serum fibrosis markers and MR-DWI parameters are of the similar ability in diagnosing liver fibrosis, but no index has the best sensitivity and specificity. The correlation between HA and SI is common reflect of active fibrosis. |
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