肝脏ADC值在慢性肝炎肝纤维化诊断中的价值

发布时间：2018-05-30 03:47

  本文选题：肝脏 + 纤维化　； 参考：《临床放射学杂志》2015年09期

【摘要】：目的探讨肝脏表观扩散系数(ADC)值在慢性肝炎活动度分级和肝纤维化分期中的临床应用价值。方法对符合纳入标准的55例慢性病毒性肝炎患者和28名正常人进行肝脏MR扩散加权成像(DWI)检查,b值选取0,600 s/mm2,并重组相应ADC图。在MR检查后1~5天内,病例组行肝穿刺活检术或肝脏病变切除术。肝穿刺活检在超声引导下进行,记录穿刺点所在肝段及对穿刺点进行标记;肝脏手术病例取病变周围的肝组织做肝纤维化病理检查,并记录取材点在大体标本上的空间位置,测量取材点与肝脏病变间的距离。利用Imagej图像处理软件对肝脏ADC值进行测量并记录。病例组肝脏ADC值测量时感兴趣区(ROI)的位置根据穿刺点或手术标本取材点的空间结构信息进行设置。病例组按肝纤维化程度将患者分为S1~S4四组,按肝脏炎症活动度将患者分为G1~G4四组。对不同G分级、S分期之间的肝ADC值进行统计分析,并对G分级、S分期与肝ADC值进行相关分析。运用受试者工作特性曲线(ROC)评估肝ADC值预测≥S1期、≥S2期及≥S3期纤维化的效能。结果肝脏ADC值随着G分级及S分期的增高而减低,G分级及S分期与肝脏ADC值之间均具有良好的负相关(r=-0.741,P=0.000及r=-0.708,P=0.000)。肝脏ADC值能区分正常组与S1~S4各组(P0.05)、≥S2与S2期纤维化(P0.05)、正常组与G1~G3各组(P0.05)、G1组与G2、G3组(P0.05)。肝脏ADC值诊断≥S1、≥S2、≥S3期纤维化的曲线下面积(AUC)、敏感性及特异性均较高,相应阈值分别为1.29×10-3mm2/s、1.27×10-3mm2/s、1.24×10-3mm2/s。结论肝脏ADC值对慢性肝炎活动度分级和肝纤维化分期的诊断具有一定的敏感性与特异性,对肝纤维化早期诊断及慢性肝炎症活动度评估有一定的参考价值。
[Abstract]:Objective to evaluate the clinical value of ADCC in the classification of chronic hepatitis activity and hepatic fibrosis. Methods 55 patients with chronic viral hepatitis and 28 normal controls were examined by Mr diffusion weighted imaging (DWI) of liver, and 0600 s / m ~ (-2) were selected and the corresponding ADC map was recombined. Within 1 ~ 5 days after Mr examination, liver biopsy or hepatectomy were performed in the case group. Liver biopsy was conducted under the guidance of ultrasound to record the location of the puncture site and the marking of the puncture site. The liver tissue around the lesion was taken for pathological examination of liver fibrosis in the liver operation case, and the space position of the sampling point on the gross specimen was recorded. The distance between the sampling point and the liver lesion was measured. The ADC value of liver was measured and recorded by Imagej image processing software. The location of the region of interest (ROI) was set according to the spatial structure information of the puncture point or the sampling point of the operation specimen in the case group when the ADC value of the liver was measured. Patients in the case group were divided into S1~S4 group and G1~G4 group according to the degree of hepatic fibrosis. The ADC value of liver was statistically analyzed among different G / S stages, and the correlation between G / S staging and liver ADC value was also analyzed. The effectiveness of liver ADC value in predicting fibrosis in 鈮，

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