基于磁共振扩散加权成像评价肝泡状棘球蚴病肝脏功能的初步研究

目的探讨扩散加权成像(diffusion weighted imaging,DWI)及表观扩散系数(apparent diffusion coefficient,ADC)值在评价肝泡状棘球蚴病(hepatic alveolar echinococcosis,HAE)肝脏功能的应用价值。材料与方法回顾性分析68例患者及30名健康志愿者,均行肝脏常规磁共振成像和DWI,b值为0和600 s/mm~2,根据Child-Pugh分级标准将病例组分为3组,A组共45例,B组共19例,C组共4例,测量正常肝实质内的ADC值,并以同层面椎管内脑脊液的ADC_椎管进行标准化处理,即ADC_比值=ADC/ADC_椎管;首先分析病例组ADC_比值与Child-Pugh评分的相关性;其次对照组与病例组采用独立样本t检验,病例组组间采用单因素方差分析。结果正常对照组ADC_比值为0.29±0.03,病例组ADC_比值为0.27±0.05,病例组A组的ADC_比值是0.28±0.05,B组ADC_比值是0.25±0.04,C组ADC_比值是0.21±0.02,病例组ADC值与Child-Pugh评分呈中度相关(r=0.432,P0.01);正常组与病例组间差异有统计学意义(P0.01),病例组A组与B组、A组与C组间差异均有统计学意义(P0.01),病例组B组与C组间差异无统计学意义(P0.05)。结论 ADC值有望评估肝泡状棘球蚴病的肝脏功能,并且随着肝脏功能的下降,ADC值逐渐降低。

Evaluating hepatic function of hepatic alveolar echinococcosis with magnetic resonance diffusion weighted imaging: initial study

Objective: To evaluate the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) for evaluating hepatic function of hepatic alveolar echinococcosis (HAE). Materials and Methods: Retrospective analysis ADC value and DWI imaging of 68 patients and 30 cases of normal people, who underwent routine liver MRI and DWI (b value were 0 and 600 s/mm2). The 68 cases of HAE patients were divided into 3 groups according to Child-Pugh classification criteria, A group has 45 cases, B group has 19 and C group has 4, the ADC value of the adjacent hepatic parenchyma was measured and standardized it with the ADC value of the cerebrospinal fulid at the same spinal cord level, that was ADCratio=ADC/ADCspinal canal. First, the correlation between ADCratioand Child-Pugh score was analyzed. Second, for the control group and case group what were used an independent-samples t test, while for the each case group what were used ANOVA. Results: The control group ADCratiowas 0.29±0.03, while the case group ADCratio was 0.26±0.05, respectively, for the more, the ADCratioof group A was 0.27±0.04, the ADCratioof group B was 0.24±0.04 and the group C was 0.21± 0.03. The statistical results showed the ADC value of the case group was moderately correlated with the Child-Pugh score (r=0.432, P<0.01). The control group and case group had significant difference (P<0.01), the ADCratioof the group A, group B and group C also had significant difference (P<0.01), but there was no difference between group B and group C (P>0.05). Conclusions: ADC value could be an indication for evaluating hepatic function for those patients with HAE. With the hepatic function decreasing, the ADC value also decreased.