| 常规弥散加权成像和弥散张量成像在肝纤维化和炎症中的诊断效能 |
| 投稿时间：2015-01-26 修订日期：2015-02-26 点此下载全文 |
| 引用本文：徐开武,姜刚录,吴江兴,冯贵华,陈东明.常规弥散加权成像和弥散张量成像在肝纤维化和炎症中的诊断效能[J].医学研究杂志,2016,45(6):97-100 |
| DOI：
10.11969/j.issn.1673-548X.2016.06.025 |
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| 基金项目:河南省教育厅自然科学研究计划项目（2011A340002） |
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| 中文摘要:目的 探讨MR传统弥散加权成像（DWI）与弥散张量成像（DTI）对慢性病毒性肝炎患者的肝纤维化程度和炎症程度定量分析的能力，评估DWI与DTI在诊断肝纤维化和炎症中的诊断效能。方法 选取笔者医院收治的58例经病理组织学诊断为慢性病毒性肝炎的患者和8例健康志愿者作为研究对象。所有研究对象都进行DWI和DTI检查，采用弥散敏感度（b值）为0、800s/mm2的单次激发快速自旋回波进行DWI和DTI检查。计算表观弥散系数（ADC）及平均弥散率（MD），分析两种方法定量肝纤维化分期的能力。对慢性肝炎患者肝穿刺病理组织检查，按照肝活检评分系统Metavir评分表对肝实质纤维化和肝炎症程度进行分级。运用Spearman相关分析探讨ADC值MD值变化和纤维化分期、炎症分级之间的相关性。结果 ADC与纤维化分期呈显著负相关（r分别为-0.939、-0.682，P<0.01）；ADC、MD值与炎症分级之间有负相关性（r分别为-0.721、-0.486，P<0.01）。结论 DWI在肝纤维化分期和肝炎炎症分级方面的诊断效能均优于DTI，ADC值可定量评价肝纤维化的分期及肝炎活动的分级。 |
| 中文关键词:弥散加权成像 弥散张量成像 肝纤维化 肝炎 |
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| Diagnostic Performance of Conventional Diffusion Weighted Imaging and Diffusion Tensor Imaging for the Liver Fibrosis and Inflammation |
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| Abstract:Objective To evaluate MR diffusion weighted imaging(DWI) and diffusion tensor imaging(DTI) for quantifying liver fibrosis and inflammation in patients with chronic viral hepatitis. Methods A total of 8 healthy volunteers and 58 patients with chronic HBV or HCV hepatitis who underwent liverbiopsy were enrolled in this study using a 3.0T MR unit at b values 0,800s/mm2. The apparent diffusion coefficient(ADC) and mean diffusion(MD) were measured in the liver parenchyma respectively and compared between patients stratified by fibrosis stage and inflammation stage. According to the Metavir scoring system score of liver biopsy, classification of hepatic parenchymatous fibrosis and hepatitis. The changes of ADC value and MD value with the correlation between fibrosis stage, inflammatory grading were amalyzed. Results ADC was negatively correlated with the staging of liver fibrosis, which was more accurate in staging than MD(r=-0.939, P<0.01; r=-0.682, P<0.01). ADC was negatively correlated with the staging of inflammation grade,which was more accurate in staging than MD(r=-0.721, P<0.01; r=-0.486, P<0.01). Conclusion The diagnostic performance of DWI was superior to DTI in liver fibrosis and hepatitis inflammatory classification. The ADC value can be used to quantitatively evaluate the staging of liver fibrosis and hepatitis activity. |
| keywords:Diffusion weighted imaging Diffusion tensor imaging Liver fibrosis Hepatitis |
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