MR形态学成像在乙型肝炎肝硬化诊断及分期中的应用价值  

Value of magnetic resonance morphological imaging in the diagnosis and differentiation of post-hepatitis B cirrhosis

作　　者：刘海峰[1,2] 许永生[1,2] 张跃 赵小菊 刘钊[1] 黎金葵 闫瑞峰 徐凯[1] 雷军强[1] LIU Haifeng;XU Yongsheng;ZHANG Yue(Department of Radiology,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院放射科,兰州730000 [2]兰州大学第一临床医学院,兰州730000

出　　处：《临床肝胆病杂志》2018年第12期2587-2591,共5页Journal of Clinical Hepatology

基　　金：兰州大学第一临床医学院卓越计划(20180060056/20180060060);甘肃省中医药管理局科研项目(GZK-2016-039)

摘　　要：目的探究MR形态学成像对乙型肝炎肝硬化诊断及鉴别的临床应用价值。方法前瞻性连续纳入2016年7月-2018年4月在兰州大学第一医院住院治疗的乙型肝炎肝硬化患者70例,其中代偿期(CHC) 32例、失代偿期(DHC) 38例,另收集30例健康志愿者为正常对照组。在标准化诊断及分期后,对研究对象行MR常规形态学检查:右叶横径(R1)、右叶矢状径(R2)、左叶横径(L1)、左叶矢状径(L2)、尾状叶横径(W1)、尾状叶矢状径(W2)、肝脏长径L1/R1、L2/R2、门静脉内径、脾静脉内径。计量资料2组间比较采用Mann-Whitney U检验; 3组间比较采用Kruskal-Wallis检验,进一步两两比较采用Mann-Whitney U检验。计数资料组间比较采用χ2检验。采用Spearman等级相关方法分析评价各参数值与不同期肝硬化的相关性。结果 R1、R2、L1、肝脏长径、L1/R1、L2/R2、门静脉内径、脾静脉内径在正常对照组和肝硬化组间比较差异均有统计学意义(U值分别为-5. 54、-5. 76、5. 26、-6. 12、6. 47、5. 08、6. 92、7. 26,P值均<0. 05); R1、L1、L1/R1、门静脉内径和脾静脉内径值在正常对照组、代偿期肝硬化组、失代偿期肝硬化组3组间两两比较差异均有统计学意义(P值均<0. 05),正常对照组的R2、肝脏长径、L2/R2分别与代偿期肝硬化组和失代偿期肝硬化组比较差异均有统计学意义(P值均<0. 05)。R1、R2、肝脏长径值随着肝硬化进展成负相关(r值分别为-0. 604、-0. 554、-0. 48,P值均<0. 001),L1、L1/R1、L2/R2、门静脉内径和脾静脉内径成正相关(r值分别为0. 635、0. 76、0. 46、0. 74、0. 42,P值均<0. 001)。结论 MR形态学变化与肝硬化进展呈较高的相关性,可作为肝硬化诊断及分期的依据。Objective To investigate the value of magnetic resonance(MR)morphological imaging in the diagnosis and differentiation of post-hepatitis B cirrhosis.Methods A prospective study was performed for 70 patients with liver cirrhosis who were consecutively admitted to The First Hospital of Lanzhou University from July 2016 to April 2018,among whom 32 had compensated hepatic cirrhosis(CHC)and 38 had decompensated hepatic cirrhosis(DHC).A total of 30 healthy volunteers were enrolled as normal control group.After standardized diagnosis and staging,MR morphological imaging was performed for all subjects to measure the indices including transverse diameter of the right lobe(R1),sagittal diameter of the right lobe(R2),transverse diameter of the left lobe(L1),sagittal diameter of the left lobe(L2),transverse diameter of the caudate lobe(W1),sagittal diameter of the caudate lobe(W2),long diameter of the liver,L1/R1,L2/R2,diameter of the portal vein,and diameter of the splenic vein.The Mann-Whitney U test was used for comparison of continuous data between two groups;the Kruskal-Wallis test was used for comparison between three groups,and the Mann-Whitney U test was used for further comparison between two groups.The chi-square test was used for comparison of categorical data between groups.Spearman rank correlation was used to investigate the correlation between each parameter and the stage of liver cirrhosis.Results There were significant differences between the normal control group and the liver cirrhosis group in R1,R2,L1,long diameter of the liver,L1/R1,L2/R2,diameter of the portal vein,and diameter of the splenic vein(U=-5.54,-5.76,5.26,-6.12,6.47,5.08,6.92,and 7.26,all P<0.05).There were significant differences in R1,L1,L1/R1,diameter of the portal vein,and diameter of the splenic vein between any two groups of the normal control group,the CHC group,and the DHC group(all P<0.05).There were significant differences between the CHC and DHC groups and the normal control group in R2,long diameter of the liver,and L2/R2(all P<0.

关 键 词：肝硬化 肝炎 乙型 磁共振成像 诊断 

分 类 号：R575.2[医药卫生—消化系统] R512.6[医药卫生—内科学]