磁共振弹性成像与扩散加权成像在肝脏纤维化分期中的对比研究  

Comparitive Study of Magnetic Resonance Elastography and Diffusion-weighted Imaging for Staging Hepatic Fibrosis

作　　者：邹立秋[1] 阮继银[1] 冯飞[1] 成官迅[1] 江锦赵[2] 

机构地区：[1]北京大学深圳医院医学影像科 [2]香港大学深圳医院放射科

出　　处：《中国医学计算机成像杂志》2015年第2期176-180,共5页Chinese Computed Medical Imaging

基　　金：广东省科技局项目No.2001B031800385~~

摘　　要：目的:比较磁共振弹性成像(MRE)与扩散加权成像(DWI)在肝脏纤维化分期中的价值。方法:制备肝纤维化模型兔44只(其中32只作为试验组,12只作为预备组),正常对照组9只。对试验兔及正常对照兔行常规MRI、MRE及DWI,测量肝实质的硬度(LS)及ADC值。试验组实验兔皮下注射CCl4后的第4、5、6、10周分别随机选择8只行MRI扫描。以肝脏纤维化病理组织学诊断为标准,采用ROC曲线比较MRE和DWI对肝脏纤维化分期的诊断效能。结果:不同分期肝脏纤维化的LS及ADC值之间存在显著差异(P<0.005)。MRE上测得的LS(r=0.838,P<0.001)与肝脏纤维化分期的相关性比ADC值更强(r=-0.527,P<0.001)。对于鉴别≥S1期及≥S2期,LS的曲线下面积(AUC)均明显大于ADC值的AUC(≥S1:0.979 vs.0.712,≥S2:0.922 vs.0.699)。MR E预测各期肝脏纤维化特异性高于DWI。结论:MR E所得LS与肝脏纤维化分期的相关性比DWI之ADC值更强,并且对预测各期肝脏纤维化均有较高的特异性。Purpose：To evaluate the diagnostic values of magnetic resonance elastography（MRE） and diffusion-weighted imaging（DWI） in staging hepatic fibrosis（HF）.Methods：The study consisted of two experimental groups：control group（n=9） and HF group（n=44）.HF group was divided into two subgroups：trial group（n=32） and reserve group（n=12）.Rabbits from control and trial group underwent MRE and DWI examinations,and the liver stiffness（LS） and ADC values were measured.In trial group,8 rabbits underwent MRI examinations at 4,5,6,10 weeks after CC14 administration.The diagnostic performance of MRE and DWI for staging HF was compared by using the receiver operating characteristic curve analysis on the basis of the histopathological analysis of HF.Results：Significant differences of LS and DWI values were present among HF stages（P〈0.005）.The LS values measured on MRE（r=0.838,P〈0.001） were more strongly correlated with the HF stages than that of ADC values measured on DWI（r=-0.527,P〈0.001）.For discriminating two stages of HF,the AUC values of LS values were significantly larger than those of ADC values（0.979 vs 0.712 for ≥S1,0.922 versus 0.699 for ≥S2）.MRE showed higher specificity for predicting all stages of HF when compared with DWI.Conclusion：MRE strongly correlated with the HF stages than that with the DWI and is more specific in predicting all HF stages.

关 键 词：肝脏纤维化 磁共振弹性成像 扩散加权成像 肝脏硬度 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]