肝脏T2值评估HBV相关慢加急性肝衰竭

发布时间：2018-04-18 19:24

本文选题：肝功能衰竭 + 磁共振成像　；参考：《中国医学影像技术》2017年06期

【摘要】：目的探讨肝脏T2值对HBV相关慢加急性肝衰竭的评估价值。方法收集HBV相关慢加急性肝衰竭(HBV-ACLF)组、慢性乙型肝炎组和正常对照组,分别对3组受检者行多回波梯度—自旋回波(M-GRASE)序列扫描,获得T2图,并计算肝脏平均T2值及T2弛豫率(R2)。收集HBV-ACLF组和慢性乙型肝炎组MR检查前2天内肝功能血液生化指标。比较3组间T2和R2值的差异及T2值与生化指标的相关性,采用ROC曲线评价T2值对HBV-ACLF的诊断效能。结果 3组间T2值(χ2=19.074,P0.001)和R2值(F=10.411,P0.001)差异均有统计学意义。T2值诊断慢加急性肝衰竭曲线下面积为0.86(P0.001),诊断阈值为57.73ms(R2=0.017)。T2值与凝血酶原时间国际标准化比值(INR)、凝血酶原时间(PT)及透明质酸(HA)呈中度正相关(rs=0.65、0.67、0.39,P均0.05),与凝血酶原活动度(PTA)、白蛋白(ALB)、前白蛋白(PA)呈中度负相关(rs=-0.67、-0.48、-0.37,P均0.05)。结论 T2或R2值可较好地反映肝脏功能情况,并与较多的肝功能实验室指标均具有相关性,对HBV-ACLF具有较好的诊断效能。
[Abstract]:Objective to evaluate the value of liver T 2 value in HBV associated chronic and acute hepatic failure.Methods the patients in HBV associated chronic and acute hepatic failure group, chronic hepatitis B group and normal control group were scanned with multi-echo gradient-spin echo M-GRASE sequence, respectively. The T 2 images were obtained, and the mean T 2 value and T 2 relaxation rate of liver were calculated.The blood biochemical indexes of liver function in HBV-ACLF group and chronic hepatitis B group were collected 2 days before Mr examination.The difference of T2 and R2 between the three groups and the correlation between T2 and biochemical indexes were compared. The ROC curve was used to evaluate the diagnostic efficacy of T2 for HBV-ACLF.Results there were significant differences among the three groups in T2 value (蠂 2 + 19.074U P 0.001) and R2 value (P 0.001). The area under the curve of slow diagnosis and acute hepatic failure was 0.86% P0.001.The diagnostic threshold was INRR, prothrombin time and prothrombin time ratio (INRR) and prothrombin time (PTT).Hyaluronic acid (HA) showed moderate positive correlation with prothrombin activity (PTAA), Albumin (Alb) and prealbumin (PAA), and was negatively correlated with the prothrombin activity (PTAA), prothrombin activity (Alb), and prealbumin (PAA), and was negatively correlated with the prothrombin activity (PTAA), prothrombin activity (Alb), and prealbumin (PAA) (P < 0. 05, P = 0. 05, P = 0. 05).Conclusion T2 or R2 values can better reflect the liver function, and are correlated with more laboratory indexes of liver function. It has good diagnostic efficacy for HBV-ACLF.
【作者单位】：西南医科大学附属医院放射科;西南医科大学附属医院传染消化科;
【分类号】：R445.2;R512.62;R575.3

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