磁共振ADC值评估慢性乙型肝炎肝纤维化程度的价值研究  

The value of liver ADC measurements in evaluating the degree of liver fibrosis in patients with chronic hepatitis B

作　　者：张鑫[1] 朱桂娟 叶晓航[1] 冯伟广[2] ZHANG Xin;ZHU Gui-juan;YE Xiao-hang(Department of Imaging,The Fourth People Hospital of Huai′an(Huai'an Jiangsu,223000)China)

机构地区：[1]淮安市第四人民医院影像科,江苏淮安223000 [2]淮安市第四人民医院肝病科

出　　处：《中西医结合肝病杂志》2023年第2期147-150,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：2020年江苏省高层次卫生人才“六个一工程”拔尖人才项目(No.LGY2020059);中国公共卫生联盟(第一批)课题项目(No.GWLM202016)。

摘　　要：目的:评估磁共振表观扩散系数(ADC)值对慢性乙型肝炎(CHB)肝纤维化分期的诊断价值。方法:选择淮安市第四人民医院2016年3月至2021年6月接受肝穿刺活检的CHB患者180例,检测所有患者肝脏磁共振ADC值。探究ADC值与肝穿刺病理纤维化分期的相关性。同时,以肝穿刺病理结果为金标准,应用受试者工作特征曲线(ROC)评估磁共振ADC值在CHB肝纤维化程度中的诊断效能。结果:肝穿刺病理结果显示F_(0)~F_(4)期患者分别有20、35、34、36和55例,各期间ADC值比较,F_(1)与F_(2)期间差异无统计学意义(P=0.230),其余各期间均差异有统计学意义(P<0.05)。相关性分析显示ADC值与CHB肝纤维化分期呈负相关(r=-0.691,P<0.001)。ROC分析结果显示,ADC值诊断肝纤维化F≥2、F≥3及F=4期患者的ROC曲线下面积(AUC)分别为0.831、0.872及0.859。结论:磁共振ADC值作为一种简单、无创的指标,对于评价CHB肝纤维化的程度具有一定的效能。Objective:To investigate the value of liver ADC measurements in evaluating the degree of liver fibrosis in patients with chronic hepatitis B(CHB).Methods:A total of 180 CHB patients who underwent liver biopsy from March 2016 to June 2021 in our hospital were included,and the liver magnetic resonance imaging ADC values of these patients were detected.To explore the correlation between ADC value and the stage of hepatic puncture pathological fibrosis.The diagnostic values of ADC value for liver fibrosis in CHB patients were assessed by the use of receiver operating characteristic(ROC)analysis.Results:Liver biopsy pathological results showed that there were 20,35,34,36 and 55 patients with stage F_(0)~F_(4),respectively.Except that there was no statistical difference between the F_(1) and F_(2) groups(P=0.230),the difference in ADC values between the other groups was statistically significant(P<0.05).ADC values decreased along the aggravation of fibrosis(r=-0.691,P<0.001).The areas under the ROC curve for the ADC value in diagnosis of liver fibrosis F≥2,F≥3 and F=4 were 0.831,0.872 and 0.859,respectively.Conclusion:The ADC value,as a simple and non-invasive index,could evaluate the degree of liver fibrosis in CHB individuals.

关 键 词：慢性乙型肝炎 肝纤维化 磁共振 ADC值 

分 类 号：R512.6[医药卫生—内科学]