【摘要】 目的 对扩散加权成像（DWI）中肝脏ADC值与MRI测量肝脾体积比值对慢性肝纤维化及肝硬化的诊断价值进行比较,探讨两者与肝纤维化病理分级的关系。方法 对31例肝纤维化及肝硬化患者和14例健康体检者行上腹部MR扫描,DWI（b=800 s/mm²）后测量肝ADC值;利用T₂ WI测量肝脾体积并计算二者比值。对上述测量结果进行统计学分析。结果 随着肝纤维化程度的加重,肝脏ADC值与之呈负相关。肝脏体积从正常肝脏到轻度肝纤维化（S1期～S2期）逐渐增大,从重度肝纤维化（S3期～S4期）到肝硬化则逐步减小;脾脏体积随着肝纤维化程度的加重而增大;肝脾体积比值则相应逐渐变小。肝脏ADC值及肝脾体积比各组及彼此之间均存在统计学差异（P<0.01）。肝脏ADC值组曲线下面积（AUC）为0.789,灵敏度为0.806,特异度为0.857;肝脾体积比组AUC为0.744,灵敏度0.742,特异度为0.714。结论 肝脏ADC值与T₂ WI肝脾体积比值评价肝纤维化及肝硬化效果良好,并与纤维化程度明显相关,前者效果更为明显,可作为肝纤维化及肝硬化早期诊断及分级的评估方法。更多还原

【Abstract】 Objective To investigate the relationship and compare the diagnosis in chronic hepatic fibrosis and cirrhosis between liver ADC value and the liver spleen volume ratio changes by MR.Methods The object included 31cases of chronic hepatic fibrosis,cirrhosis and 14 cases of control group.The liver ADC value(b=800 s/mm~2) and the liver spleen volume ratio in different fibrosis stages were measured.Analysis of variances was performed to compare the difference between the two groups.Results The right lobe of liver ADC value and the liver spleen volume ratio in each group was significant(P<0.01).With the increase of fibrosis score,liver ADC was correlated negatively.From normal to mild cirrhosis(S1-S2),the total liver volume increased progressively.From severe hepatic fibrosis to advanced cirrhosis(S3-S4),it decreased slowly and spleen volume increased gradually along as cirrhosis degree,while the liver spleen volume ratio correspondingly decreased.Area under the curve(AUC) in the group of liver ADC value was 0.789,sensitivity was 0.806,and specificity was 0.857.The group of liver spleen volume ratio AUC was 0.744,sensitivity was 0.742,and specificity was 0.714.Conclusion The correlation of the two methods for evaluating the effectiveness of liver fibrosis and cirrhosis are both significant.Whereas,ADC value was better for liver fibrosis,which is the best method for diagnosis of early liver fibrosis.更多还原