药物性肝损伤患者磁共振成像表现及诊断价值分析  

Magnetic Resonance Imaging Findings of Drug-Induced Liver Injury and Diagnostic Value Analysis

作　　者：姚均 瞿献莉 袁梅 Yao Jun;Qu Xian-li;Yuan Mei(Department of Imaging,Qinhuai Medical District,Eastern Theater General Hospital,Nanjing 210002,Jiangsu Province,China)

机构地区：[1]东部战区总院秦淮医疗区影像科,江苏南京210002

出　　处：《中国社区医师》2023年第5期112-114,共3页Chinese Community Doctors

摘　　要：目的:观察药物性肝损伤患者磁共振成像(MR)表现,探讨其诊断价值。方法:选取2011年1月—2020年12月东部战区总院秦淮医疗区收治的42例药物性肝损伤患者作为试验组,选取同期18例健康成年人作为对照组,两组均行上腹部MR平扫和增强检查,比较试验组治疗前后肝功能主要指标水平,观察两组MR表现,分析两组表观弥散系数(ADC)差异及试验组ADC值与肝功能指标水平之间的相关性。结果:试验组治疗后总胆红素、直接胆红素、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转肽酶均低于治疗前,差异有统计学意义(P<0.05)。试验组患者肝实质在T2WI和弥散成像序列(DWI)上呈弥漫性不均匀信号38例,粟粒样或斑片状强化21例,汇管区水肿35例,慢性胆囊炎8例,胆管结石2例,肝硬化2例,后腹膜淋巴结肿大1例。2例患者治疗后肝脏T2WI和DWI信号明显改善。试验组ADC值低于对照组,差异有统计学意义(P<0.001)。治疗前,试验组ADC值与总胆红素、直接胆红素、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转肽酶水平均无明确相关性,差异无统计学意义(P>0.05)。结论:药物性肝损伤的MR征象不具有特异性,但MR能够敏感地显示病变,在诊断和疗效评估中起重要作用。Objective:To observe the findings of magnetic resonance(MR)imaging in patients with drug-induced liver injury and explore its diagnostic value.Methods:A total of 42 patients with drug-induced liver injury who were admitted to Qinhuai Medical District of Eastern Theater General Hospital from January 2011 to December 2020 were selected as the experimental group,and 18 healthy adults during the same period were selected as the control group.Both groups underwent upper abdominal MR plain scanning and enhanced scanning examinations.The main indexes of liver function in the experimental group were compared before and after treatment.MR findings in two groups were observed.The difference of apparent diffusion coefficient(ADC)value between two groups and the correlations between ADC value and index level of liver function in the experimental group were analyzed.Results:After treatment,total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,andγ-glutamyl transpeptidase in the experimental group were lower than those before treatment,and the difference was statistically significant(P<0.05).In the experimental group,the diffuse inhomogeneous signal of liver parenchyma on T2WI and diffusionweighted imaging(DWI)were displayed in 38 cases,miliary or patchy enhancement in 21 cases,edema in the portal area in 35 cases,chronic cholecystitis in 8 cases,calculus of bile duct in 2 cases,liver cirrhosis in 2 cases,and retroperitoneal adenophyma in 1 case.The liver T2WI and DWI signals were significantly improved after treatment in 2 patients.The ADC value in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.001).Before treatment,there was no clear correlation between the ADC values and the total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,andγ-glutamyl transpeptidase levels in the experimental group,and the difference was not statistically significant(P>0.05).Conclusion:The MRI findings of drug-induced

关 键 词：药物性肝损伤 磁共振成像 诊断 

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