| 崔恩铭,龙晚生,罗学毛,兰勇,谭国强,左克扬,李青.多b值弥散加权成像评估肝纤维化程度[J].中国医学影像技术,2013,29(10):1674~1678 |
| 多b值弥散加权成像评估肝纤维化程度 |
| Multi-b values DWI in evaluation on staging of liver fibrosis |
| 投稿时间：2013-06-20 修订日期：2013-07-25 |
| DOI： |
| 中文关键词: 肝硬化 扩散磁共振成像 表观扩散系数 |
| 英文关键词:Liver cirrhosis Diffusion magnetic resonance imaging Apparent diffusion coefficient |
| 基金项目:江门市科学技术项目[2013]81-44 |
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| 中文摘要: |
| 目的 探讨多b值DWI评估肝纤维化程度的价值及脂肪含量对ADC值的影响.方法 对39例慢性肝炎患者(包括乙型肝炎35例,丙型肝炎4例)行多b值DWI.通过肝穿活检行病理组织学检查,按纤维化程度及脂肪含量进行分期、分组,并对组间ADC值及相关性进行统计分析.结果 各b值条件下,随着肝纤维化程度加重,其ADC值呈下降趋势:b=50、100、200 s/mm2时,S4期与S0、S1期之间差异有统计学意义(P均<0.05);b=400、600、800 s/mm2时,S0期与S2期及S0、S1、S2期与S3、S4期之间差异均有统计学意义(P均<0.05).b=100、200、400、600、800 s/mm2时,ADC值与肝纤维化程度均有相关性(P均<0.05).b=600 s/mm2时,利用平均ADC值诊断≥S2期的AUC为0.88,以ADC=0.54×10-3mm2/s为阈值,诊断敏感度为88.2%,特异度为72.7%;诊断≥S3期的AUC为0.87,以ADC=0.52×10-3mm2/s为阈值,诊断敏感度为82.1%,特异度为81.8%.当b=100、200、400、600、800 s/mm2时,脂肪含量与ADC值有相关性(P均<0.05).结论 选取合适的b值时,ADC值能客观反映肝纤维化程度;评估时应将灌注减低、结构异常、脂肪沉积等多个影响因素考虑在内. |
| 英文摘要: |
| Objective To investigate the value of multi-b values DWI for assessment on staging of liver fibrosis, as well as the impact of fat deposition on ADC values. Methods Totally 39 patients with chronic viral hepatitis including 35 hepatitis B and 4 hepatitis C underwent multi-b DWI. Liver biopsy was performed 1 day after DWI. According to the stages of liver fibrosis and fat content, the patients were divided into different groups, and statistical analysis for ADC values and their correlation with liver fibrosis and fat deposition was performed. Results With the progress of liver fibrosis, ADC values decreased gradually. When b=50, 100, 200 s/mm2, respectively, there were statistical differences of ADC values among S4 and S0, S1 (all P<0.05). When b=400, 600, 800 s/mm2, respectively, there were statistical differences of ADC values between S0 and S2, among S0, S1, S2 and S3, S4 (all P<0.05). When b=100, 200, 400, 600, 800 s/mm2, respectively, there were correlation between ADC values and stages of liver fibrosis (all P<0.05). When b=600 s/mm2, the area under ROC curve for prediction of liver fibrosis ≥S2 and ≥S3 was 0.88 and 0.87, respectively. Taking ADC 0.54×10-3 mm2/s and 0.52×10-3 mm2/s as threshold, the sensitivity was 88.2% and 82.1%, specificity was 72.7% and 81.8%, respectively. When b=100, 200, 400, 600, 800 s/mm2, respectively, there were correlation between fat content and ADC values (all P<0.05). Conclusion ADC values can objectively reflect the stages of liver fibrosis in chronic hepatitis when b value is suitable, while many factors including perfusion reduction, abnormal structure and fat deposition should be taken into account. |
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