多b值弥散加权成像对乙肝肝硬化分级的诊断价值探讨  

Diagnostic value of liver cirrhosis based on magnetic resonance diffusion weighted imaging with different liver lobes

作　　者：叶飒飒 舒震宇[1] 徐建国[1] 郑劼[1] 

机构地区：[1]浙江省人民医院放射科,浙江杭州310014

出　　处：《医学影像学杂志》2017年第11期2139-2143,共5页Journal of Medical Imaging

摘　　要：目的探讨乙肝肝硬化患者不同肝叶磁共振弥散加权成像不同b值对肝硬化Child-Pugh分级的诊断价值。方法收集72例乙肝肝硬化患者和23例健康志愿者,其中肝硬化患者按Child-Pugh评分系统分为A、B、C三组分别为22例、26例和24例,均行肝脏MR-DWI扫描,设定不同的弥散敏感系数(b值)分别为0s/mm2、400s/mm2、600s/mm2、800s/mm2,测定每个受试者不同b值下肝脏各叶的ADC值。分别统计各b值肝左外叶、肝左内叶、肝右叶和肝尾状叶的ADC值,分析不同肝叶ADC值与Child-Pugh分级的相关性,使用ROC曲线评估肝叶ADC值对肝硬化分级的诊断效能。结果在不同b值下,肝硬化组肝脏ADC值均低于正常对照组,且各肝叶ADC值与肝硬化Child-Pugh分级均呈负相关(P<0.05)。结论 DWI可以对乙肝肝硬化进行定量检查,有助于临床早期无创伤性评估肝硬化分级。Objective To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging （DWI） using multiple b values with Child-Pugh class of cirrhosis in patients with hepatitis B. Methods Seventy-two cirrhotic patients with hepatitis B and twenty-five healthy volunteers underwent DWI with difference b values. The apparent diffusion coeffi- cients values of different liver lobes were measured at different b values of each subject. Apparent diffusion coefficients of left lat- eral liver lobe （LLL）, teft medial liver lobe （LML）, fight liver lobe （RL） and caudate lobe （CL） for difference b values were analyzed statistically to evaluate cirrhosis with Child-Pugh staging. We used ROC curves to assess hepatic cirrhosis grading ADC was diagnostic performance. Results Liver cirrhosis ADC were lower than the control group in difference b values, and inversely correlated with Child-Pugh class in LLL, LML, RL and CL （ P 〈 0.05）. Conclusion DWI can perform quantitative examina- tion of liver cirrhosis, which contributes to the clinical evaluation of early noninvasive diagnosis of cirrhosis classification.

关 键 词：肝硬化 磁共振成像 CHILD-PUGH分级 乙型肝炎 

分 类 号：R657.3[医药卫生—外科学] R445.2[医药卫生—临床医学]