摘要
目的探讨扩散加权成像(DWI)、体素内不相干运动成像、T1 mapping成像和血清学诊断模型中天门冬氨酸氨基转移酶/血小板比值指数(APRI)、FIB-4指数及其联合应用在肝纤维化分期中的价值。资料与方法回顾性收集2020年3月—2021年3月就诊于中国科学院大学宁波华美医院经病理证实为肝纤维化的45例患者,根据肝纤维化程度分为S0~S1组、S≥2组和S≥3组,根据血清学指标计算APRI和FIB-4,采用3.0T超导MR行多b值DWI和T1 mapping扫描,测量表观扩散系数(ADC)、真实扩散系数(D)、假性扩散系数(D*)、灌注分数(f)和T1弛豫时间,绘制受试者工作特征曲线,比较各参数及联合应用诊断肝纤维化分期的效能。结果D、ADC、T1弛豫时间、APRI、FIB-4诊断肝纤维化S≥2的曲线下面积分别为0.862、0.840、0.624、0.747、0.653;D、ADC、T1弛豫时间、APRI、FIB-4诊断肝纤维化S≥3的曲线下面积分别为0.800、0.760、0.786、0.893、0.676;ADC联合APRI、D联合FIB-4诊断肝纤维化S≥3的敏感度均为100.0%。ADC联合T1弛豫时间诊断肝纤维化S≥2、S≥3的特异度分别为93.3%、94.3%。结论ADC、D、T1弛豫时间和APRI对各期肝纤维化均具有一定的诊断价值。ADC联合APRI、D联合FIB-4、ADC联合T1弛豫时间可以弥补单一诊断方法的不足,为临床诊断提供参考。
Purpose To explore the clinical value of diffusion weighted imaging(DWI),intravoxel incoherent motion(IVIM),T1 mapping imaging and aspartate aminotransferase to platelet ratio index(APRI),FIB-4 and their combined application of serological diagnostic models in the staging of liver fibrosis.Materials and Methods Forty-five patients with liver fibrosis who confirmed by liver biopsy in Hwa Mei Hospital,University of Chinese Academy of Sciences were included in our study between March 2020 and March 2021.According to pathological results,all patients were divided into S0-S1,S≥2 and S≥3 group.APRI and FIB-4 were calculated based on the serological indexes.With a 3.0T MR scanner,IVIM diffusion imaging was acquired using the sequences with a b-value series and T1 mapping.Apparent diffusion coefficient(ADC),actual diffusion coefficient(D),pseudo diffusion coefficient(D*),perfusion fraction(f)and T1 relaxation time were further measured.The receiver operator characteristic curves were plotted to compare the efficacy of each parameter and its combined application in the diagnosis of liver fibrosis.Results The area under the curve(AUC)of D,ADC,T1 relaxation time,APRI and FIB-4 for diagnosis of S≥2 was 0.862,0.840,0.624,0.747 and 0.653,respectively.The AUC of D,ADC,T1 relaxation time,APRI and FIB-4 for diagnosing S≥3 was 0.800,0.760,0.786,0.893 and 0.676,respectively.The sensitivity of ADC combined with APRI,and D combined with FIB-4 in the diagnosis of S≥3 was all 100.0%.The specificity of ADC combined with T1 relaxation time in diagnosing S≥2 and S≥3 was 93.3%and 94.3%,respectively.Conclusion ADC,D,T1 relaxation time and APRI have certain diagnostic value in each stage of liver fibrosis.ADC combined with APRI,D combined with FIB-4,and ADC combined with T1 relaxation time can supplement the deficiency of single diagnostic method,providing evidence in clinical practice.
作者
刘瑞瑞
郑建军
张景峰
陈斌
崔诗浛
闫昆
LIU Ruirui;ZHENG Jianjun*;ZHANG Jingfeng;CHEN Bin;CUI Shihan;YAN Kun(Department of Radiology,Hwa Mei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第2期116-122,138,共8页
Chinese Journal of Medical Imaging
基金
宁波市影像医学临床医学研究中心(2021L003)
宁波市省市共建重点学科。
