摘要
目的探讨磁共振单、双指数模型扩散加权成像(DWI)诊断慢性乙型肝炎肝纤维化的临床价值。方法收集2015年1月-2017年12月期间在解放军总医院第五医学中心行肝脏DWI及体表内不相干运动(IVIM)检查并经病理学证实的不同分期的慢性乙型肝炎肝纤维化患者,同期招募的15名健康志愿者进行对照,计算单指数模型的参数表观扩散系数(ADC)和双指数模型真扩散系数(D)值、假性扩散系数(D*)值、灌注分数(f)值等。统计学分析对照组与肝纤维化组各参数的均值采用独立样本t检验方法;对不同肝纤维化程度的各参数值采用单因素方差分析;采用受试者工作特征曲线(ROC)分析参数对肝纤维化≥S2期、≥S3期的诊断效能。结果对照组与肝纤维化组ADC值、D值、D*值、f值的差异都有统计学意义(P<0.05);肝纤维化组不同分级之间的ADC值、D*值、f值组间差异亦有统计学意义(P<0.05);D*值诊断肝纤维化≥S2、S3级的诊断效能最高,AUC=0.746、0.796,灵敏度与特异度分别为68.42%、77.78%,80.77%、73.33%。结论DWI单指数、双指数模型技术参数均可用来评估慢性乙型肝炎所致肝纤维化严重程度,其中双指数模型的参数D*值的诊断效能最高,对临床治疗及预后随访有一定的参考价值。
Objective To investigate the clinical value of MR mono-exponential and bi-exponential diffusion weighted imaging(DWI) in the diagnosis of liver fibrosis in patients with hepatitis B. Methods Between January 2015 and December 2017, subjects were recruited from patients with hepatitis B liver fibrosis of different stages confirmed by pathology and examined by DWI and IVIM-DWI in our hospital, while another 15 healthy volunteers served as controls.ADC values of mono-exponential model parameters, true diffusion coefficient(D) values, pseudo diffusion coefficient(D*) values and perfusion fraction(f) values of bi-exponential model parameters were calculated. The independent sample t test was used to compare the parameters between the liver fibrosis group and the control group. Single factor analysis of variance was used to compare the parameters of different degrees of liver fibrosis. The receiver operating curve(ROC) was used to analyze the diagnostic efficiency of parameters for liver fibrosis ≥S2 and ≥S3. Results There was significant difference in ADC values, D values, D* values and f values between the control group and the liver fibrosis group(P<0.05).In addition, these values were significantly different between patients with different degrees of liver fibrosis(P<0.05). The diagnostic efficiency of D * values in diagnosis of liver fibrosis ≥S2 and S3 was the highest(AUC = 0.746, 0.796), and the sensitivity and specificity were 68.42%, 77.78%, 80.77%, and 73.33% respectively. Conclusion Mono-exponential and biexponential model DWI parameters can be used to determine the degree of liver fibrosis in patients with chronic hepatitis B. The diagnostic efficacy of bi-exponential model parameter D* is the highest, which is of referential value for clinical treatment and prognosis follow-up.
作者
吴燕
周健涛
史纯纯
张晓莉
刘渊
WU Yan;ZHOU Jiantao;SHI Chunchun;ZHANG Xiaoli;LIU Yuan(Northern Medical District,The General Hospital of PLA,Beijing 100094,China;不详)
出处
《空军医学杂志》
2021年第6期485-488,共4页
Medical Journal of Air Force
基金
首都临床特色应用研究(北京市科技计划项目)(Z181100001718006)。
关键词
磁共振成像
诊断
扩散加权成像
肝纤维化
乙肝
体素内不相干运动
magnetic resonance imaging
diagnosis
diffusion weighted imaging
liver fibrosis
hepatitis B
intravoxel incoherent motion
