MR体素内不相干运动扩散加权成像评估慢性乙型病毒性肝炎肝纤维化程度的价值研究

目的探讨体素内不相干运动扩散加权成像对慢乙肝肝纤维化程度评估的价值。材料与方法 55例慢乙肝患者根据肝穿病理分为无和轻度肝纤维化组、中度肝纤维化组和重度肝纤维化组,20例健康志愿者为对照组。行磁共振IVIM-DWI等检查。分析对照组与肝纤维化组之间以及肝纤维化各组之间的sADC、D、D*及f值的差异。结果随着肝纤维化程度的加重,肝组织的D、D*及f值均逐渐减低,D值在对照组与肝纤维化组之间有统计学差异。D*及f值在对照组与肝纤维化组之间以及肝纤维化各组之间的差异均有统计学意义。对照组与肝纤维化组的D、D*及f值分别是(0.540±0.031)×10~(-3) mm~2/s和(0.427±0.061)×10~(-3) mm~2/s、(0.380±0.027)×10~(-1) mm~2/s和(0.320±0.052)×10~(-1) mm~2/s、(0.232±0.014)和(0.217±0.011),无和轻度肝纤维化组的D、D*及f值分别是(0.489±0.027)×10~(-3) mm~2/s、(0.349±0.041)×10~(-1) mm~2/s、(0.226±0.010),中度组的分别是(0.398±0.035)×10~(-3) mm~2/s、(0.317±0.040)×10~(-1) mm~2/s、(0.214±0.008),重度组的分别是(0.370±0.048)×10~(-3) mm~2/s、(0.269±0.055)×10~(-1) mm~2/s、(0.206±0.006)。结论磁共振IVIM-DWI参数D、D*及f值可大致反映慢乙肝肝纤维化的严重程度,具有潜在的临床应用价值,尤其可用于早期肝纤维化的无创性评估。

The value of MR intravoxel incoherent motion diffusion weighted imaging in evaluating the degree of liver fibrosis of chronic hepatitis B

Objective: To investigate the value of IVIM diffusion weighted imaging in the assessment of liver fibrosis in patients with chronic hepatitis B. Materials and Methods: Fifty-five cases of patients with chronic hepatitis B were divided into no and mild liver fibrosis group, moderate liver fibrosis group and severe liver fibrosis group according to liver biopsy pathology and selected 20 healthy volunteers as control group. All of the subjects have received 3.0 T magnetic resonance IVIM-DWI et al. The difference of sADC, D, D* and f value between the normal control group and the liver fibrosis group and between the liver fibrosis groups were statistically analyzed. Results: With the progression of liver fibrosis, the D, D* and f value of liver were gradually reduced. There was signicficant difference in D value between the normal control group and the liver fibrosis group. There was signicficant difference in D* and f value between the normal control group and the liver fibrosis group and between the liver fibrosis groups. The D, D* and f values in normal control group and liver fibrosis group respectively were (0.540±0.031)×10-3 mm2/s and (0.427±0.061)×10-3 mm2/s, (0.380±0.027)×10-1 mm2/s and (0.320±0.052)×10-1 mm2/s, (0.232±0.014) and (0.217±0.011). The D, D* and f values in no and mild liver fibrosis group respectively were (0.489±0.027)×10-3 mm2/s, (0.349±0.041)×10-1 mm2/s, (0.226±0.010). The D, D* and f values in moderate liver fibrosis group respectively were (0.398±0.035)×10-3 mm2/s, (0.317±0.040)×10-1 mm2/s, (0.214±0.008). The D, D* and f values in severe liver fibrosis group respectively were (0.370±0.048)×10-3 mm2/s, (0.269±0.055)×10-1 mm2/s, (0.206±0.006). Conclusions: The parameters D, D* and f value of MR IVIM-DWI can approximately reflect the severity of liver fibrosis in patients with chronic hepatitis B, has potential value in clinical application, especially can be used for the noninvasive assessment of liver fibrosis in the early stage.