3.0T磁共振扩散加权成像在乙肝肝硬化严重程度评价中的应用  

The Research of Diffusion Weighted Imaging by 3. 0T MR in the Evaluation of Hepatic B Cirrhosis

作　　者：殷鑫[1] 陈勇[2] 高知玲[2] 朱凯[2] 贾晶[1] 马彩花 冀鑫[1] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院放射科,银川750004

出　　处：《宁夏医科大学学报》2015年第1期25-28,F0003,共5页Journal of Ningxia Medical University

基　　金：国家自然基金(61061005;61440043)

摘　　要：目的探讨3.0T磁共振（MR）扩散加权成像（DWI）在乙肝肝硬化患者肝功能评价中的应用。方法本组收集乙肝肝硬化病例44例,男35例,女9例,年龄25~67岁,平均50.6岁,其中Child-Pugh A级22例,B级14例,C级8例。均采用3.0T磁共振扫描仪,扫描序列SE/EPI,对肝脏行DWI扫描,b值分别取50、500、1000s·mm^-2,并测量肝脏组织的表观扩散系数（ADC）值及DWI图像信噪比（SNR）,分析比较相同b值条件下肝脏ADC值在Child A、B、C级之间的差别,以及不同b值时肝脏ADC值及DWI图像质量。结果随着b值的增大,肝硬化患者肝脏ADC值及图像SNR明显下降（P〈0.05）;同一b值时,随着肝硬化Child分级的增加,肝实质ADC值减低（P〈0.05）;当b值分别为50、500、1000s·mm^-2时,Child A、B、C级肝硬化患者肝脏ADC值依次减低（P〈0.05）;当b=50 s·mm^-2时,Child-Pugh A、B、C三级两两比较,均存在统计学差异（P〈0.05）;当b=500 s·mm^-2时,Child-Pugh A、B、C三级两两比较,差异均有统计学意义（P〈0.05）;b=1000s·mm^-2时,Child A级ADC值高于B级和C级（P〈0.05）,Child B与Child C差异无统计学意义（P〉0.05）。当b值分别取50、500、1000s·mm^-2时,肝实质ADC值与Child-Pugh评分之间呈负相关（r=-0.563、-0.818、-0.750（P均〈0.05）。结论 DWI可以间接反应肝脏组织生理状态,是检测、定量和评价肝硬化严重程度的影像学方法。Objective To investigate the practical operation and use of 3. 0T diffusion- weighted MR imaging in the evaluation of hepatitis B cirrhosis. Methods 44 patients with Hepatic B Cirrhosis（ 35 males,9 females,mean age of 50. 6 years,range from 25 to 67 years） were evaluated,who underwent magnetic resonance imaging of the upper abdomen at 3. 0T,including spin echo- echoplanar diffusion- weighted imaging using b values of 50,500 and 1000 s·mm^-2. Measuring ADC and Signal- to- noise ratio（ SNR） of the liver in the conditions of the different b values,liver ADC between patients in different Child- Pugh stages were compared. Meanwhile,we compared liver ADC and SNR between patients under different b values. Results Liver ADC and SNR values measured in DWI using higher b values were found to be significantly lower than using lower b values（ P〈0. 05）. There were significant differences in liver ADC among Child A,B and C level（ P〈0. 05）,when b values were 50 s · mm^-2. There were significant differences in liver ADC among Child A,B and C level（ P〈0. 05）,when b values were 500 s·mm^-2. There were significant difference in liver ADC between A level and B level（ P〈0. 05） and between A and C level（ P〈0. 05）,when b value was1000 s·mm^-2. when b value were 50,500 and 1000 s·mm^-2,liver ADC were significantly negatively correlated with Child score（ P〈0. 05）,correlation coefficients were- 0. 563,- 0. 818,- 0. 750（ P〈0. 05）.Conclusion Diffusion- weighted MRI can indirectly reflect the physiological state of the liver tissue,and it is an important imaging method for detection and quantification and evaluation of serious degree of liver cirrhosis.

关 键 词：磁共振成像 扩散加权成像 肝硬化 CHILD-PUGH分级 

分 类 号：R445.2[医药卫生—影像医学与核医学]