【摘要】 目的初步探讨脾脏体素不相干运动扩散加权成像(IVIM-DWI)在肝硬化Child-Pugh分级中的应用价值。方法纳入观察60例肝硬化患者(Child-Pugh分级:A级20例,B级20例,C级20例),所有受试者均行脾脏多b值DWI检查。分别测量脾脏单指数[标准扩散系数(ADC-stand)]、双指数[慢速扩散系数(ADC-slow)、快速扩散系数(ADC-fast)和扩散分数(f)]及拉伸指数模型参数[分布扩散系数(DDC)和拉伸因子(α)],比较脾脏在肝硬化不同Child-Pugh分级间各参数值的差异;采用ROC曲线评价各参数值诊断阈值及效能。结果脾脏ADC-fast值在A、B、C级分别为9.021±0.171、7.781±0.131、6.665±0.152,组内两两比较差异有统计学意义(P<0.05),分别选择合适的诊断阈值,可使上述敏感度及特异度均达到65.0%及以上。脾脏ADC-stand值、ADC-slow值、f值、DDC值、α值三组之间均无统计学意义。结论脾脏IVIM-DWI中的ADC-fast值有助于临床进行肝硬化程度分级。更多还原

【Abstract】 Objective To investigate the value of splenic intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) in Child-Pugh grading of cirrhotic patients. Methods Totally, 60 patients with liver cirrhosis underwent multi-b values DWI. Among them, 20 cases were in grade A, 20 cases were in grade B, 20 cases were in grade C. The monoexponential model parameters(ADC-stand), biexponential model parameters(ADC-slow, ADC-fast, f) and stretched-exponential model values [distributed diffusion coefficient(DDC),α] were measured, respectively. Then the parameters were compared among the three groups, the thresholds and diagnostic efficiency of the parameter values were evaluated with ROC curve. Results ADC-fast values of grade A, B, C of spleen in portal phase were 9.021±0.171, 7.781±0.131, 6.665±0.152, respectively. There were significant differences between each two groups(P<0.05); When appropriate threshold values were taken, all the sensitivity and specificity were greater than or equal to 65.0%. There was no significant difference in ADC-stand, ADC-slow, f, DDC and α values of spleen among the three groups. Conclusion The value of ADC-fast in splenic IVIM-DWI may be helpful in grading the liver cirrhosis.更多还原