扩散峰度成像评估慢性乙型肝炎患者肝炎活动度的价值

目的探讨扩散峰度成像评估慢性乙型肝炎患者肝炎活动度的可行性及价值.资料与方法回顾性分析2015年12月—2018年2月天津市第一中心医院52例有肝脏穿刺病理结果的慢性乙型肝炎患者(研究组)和24例健康志愿者(对照组)的肝脏扩散峰度成像资料,并收集研究组的肝功能实验室指标.测量所有研究对象的肝脏平均扩散率(MD)和平均峰...

MR Diffusion Kurtosis Imaging in Evaluating Hepatitis Activity of Patients with Chronic Hepatitis B

Purpose To study the feasibility and value of diffusion kurtosis imaging(DKI)in evaluating hepatitis activity in patients with chronic hepatitis B.Materials and Methods The liver DKI data of 52 patients with chronic hepatitis B and 24 healthy volunteers in Tianjin First Center Hospital from December 2015 to February 2018 were retrospectively analyzed,and the laboratory indexes of liver function in patients with chronic hepatitis B were further collected.Mean apparent diffusion(MD)and mean kurtosis(MK)were measured in all subjects.The patient group was graded according to the liver biopsy results(G0-G3),and the healthy group was defaulted to G0.The differences of MD and MK values between two groups with different degrees of hepatitis activity were compared,and the correlation between MD and MK values and hepatitis activity grade was also analyzed.Partial correlation analysis was conducted with the degree of liver fibrosis as a control variable.Receiver operating characteristic curve was performed to analyze the differential diagnosis efficiency of MD for different degrees of hepatitis activity.Results There were significant differences in MD value among different degree of hepatitis activity groups(F=13.234,P<0.01),and there were statistically significant differences in liver MD values between G0 group(1.58±0.08),G1 group(1.58±0.09),G2 group(1.54±0.13)and G3 group(1.32±0.09)(all P<0.01)based on the comparison between groups with different degree of hepatitis activity.The MD value was showed moderately negative correlation with hepatitis activity(r=-0.423,P<0.01).There was no statistical difference in MK value among different degree of hepatitis activity groups(F=0.012,P=0.998),and there was no significant correlation between MK value and hepatitis activity grade(r=0.010,P=0.935).When the degree of liver fibrosis was used as the control variable,the MD value was presented low negative correlation with hepatitis activity(r=-0.255,P=0.027).The area under curve(AUC)values of liver MD of≥G1,≥G2 and≥G3 stage were 0.66,0.69 and 0.96,respectively.Conclusion MD derived from DKI can be used to evaluate hepatitis activity in patients with chronic hepatitis B,especially accurately discriminating the severe inflammation patient.