摘要
目的探讨T2WI序列肝脏信号强度指标联合常规MRI征象对慢性乙型肝炎炎症活动度的诊断价值。方法选取2014年1月至2015年12月在本院接受治疗的129例慢性乙型肝炎患者作为炎症组,同时选取23名健康志愿者作为对照组。对入组者行肝脏MRI平扫及动态增强扫描,并在MRI检查后2天内行肝脏穿刺活检,根据病理结果依据炎症活动度将炎症组分为G1级、G2级、G3-4级,在脂肪抑制T2加权成像（FS T2WI）序列测量肝脏信号强度与右侧竖脊肌信号强度的比值（SII）,并进行统计学分析,同时分析炎症组各级别的MRI特征性表现。结果炎症组与对照组、G1与G2、G1与G3-4级间SII值差异有统计学意义（P〈0.05）;G2与G3-4级间SII值差异无统计学意义（P〉0.05）。绘制受试者工作特征曲线（ROC）,SII值、SII值联合常规MRI征象诊断G2级以上炎症活动度的曲线下面积（AUC）=0.86、0.92,敏感度为74.4%、90.2%,特异度为82.2%、79.5%。结论 SII值联合常规MRI征象在对慢性乙型肝炎炎症活动度的诊断效能较高。
Objective To study the MRI features of inflammatory activity at all levels in patients with chronic hepatitis B,so as to aid clinical treatment and improve evaluation of prognosis. Methods We chose cases which presented to our hospital from January 2014 to December 2015 for treatment with 129 cases of patients with chronic hepatitis B as the inflammation group,and at the same time 23 cases of healthy people were chosen as control group. All cases were performed MR plain scan and dynamic enhanced scan for liver,and performed liver biopsy within two days. According to the degree of inflammatory activity（ G）,the inflammation group was divided into G1,G2 and G3-4 level. The SII was calculated as the signal intensity ratio between the hepatic parenchyma and the right erector spinae muscles on the same section of FS T2 WI MR images for all included cases,and then the data was statistically analyzed; furthermore,MRI features of inflammation group at all levels were also analyzed. Results The SII showed statistical significance（ P 0. 05） between the inflammation group and control group,and there was statistical significance（ P 0. 05） between G1 and G2、G1 and G3-4 level,there is no statistical significance between G2 and G3-4 level. SII、SII combined with conventional MRI signs of ROC in diagnosis of G2 and above group showed the area under the curve（ AUC） was 0. 86、0. 92,the sensitivity and the specificity was 74. 4% 、90. 2% and 82. 2% 、79. 5% respectively. Conclusion SII combined with conventional MRI signs shows higher diagnostic efficiency in evaluating the degree of inflammation activity in patients with chronic hepatitis B,it is worthy of clinical application.
作者
任洪伟
安维民
刘渊
刘长春
董景辉
REN Hongwei;AN Weimin;LIU Yuan(Department of Radiology,302 Hospital of PLA,Beijing,100039,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第8期1308-1312,共5页
Journal of Clinical Radiology
基金
全军医学科技青年培育项目(编号:14QNP111)
关键词
乙型肝炎
慢性
磁共振成像
炎症活动度
Hepatitis B,chronic
Magnetic resonance imaging
Inflammation activity
