中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
1期
65-69
,共5页
石喻%郭启勇%廖伟%马跃%乞文旭
石喻%郭啟勇%廖偉%馬躍%乞文旭
석유%곽계용%료위%마약%걸문욱
肝硬化%纤维化%磁共振成像,扩散%肝炎
肝硬化%纖維化%磁共振成像,擴散%肝炎
간경화%섬유화%자공진성상,확산%간염
Liver cirrhosis%Fibrosis%Diffusion magnetic resonance imaging%Hepatitis
目的 探讨MR DWI对肝纤维化程度定量分析的能力.方法 应用1.5 T MR对12名志愿者、47例慢性乙型或丙型肝炎患者进行常规扫描及DWI检查,b值选择0、250、500、750及1000 s/mm~2,联合b值b_(250～1000)及b_(500～1000)分别取b=250、500、750和1000 s/mm~2及b=500、750和1000 s/mm~2的ADC平均值.采用Scheuer法进行纤维化(S)分期和炎症(G)分级,探讨病理分期与ADC值的相关性,采用Mann-Whitney U检验及Logistic回归分析评价ADC预测不同纤维化分期的能力.结果 当b=750 s/mm~2时,S0、S1、S2、S3、S4期纤维化下ADC平均值分别为(1.41±0.11)×10~(-3)、(1.37±0.09)×10~(-3)、(1.27±0.05)×10~(-3)、(1.26±0.04)×10~(-3)、(1.22±0.06)×10~(-3)mm~2/s,ADC值在不同S分期间差异最大(F=18.31,P<0.01).随着S分期的增加,各b值下的ADC平均值逐渐下降,两者存在负相关性,b_(250～1000)相关性最强(r=-0.727,P<0.01).选择b_(750)及b_(250～1000)、b_(500～1000)时,ADC值在S2期以上(与S0和S1相比)及S3期以上(与S0和S1相比)纤维化时均明显降低(P<0.01);在预测S2期以上纤维化时,选择b(750)时曲线下面积(AUC)最大(0.909),敏感性85.7%,特异性100.0%(ADC标准≤1.35×10~(-3)mm~2/s);在预测S3期以上纤维化时,选择b_(250～1000)时AUC最大(0.864),敏感性69.6%,特异性95.8%(ADC标准≤1.53×10~(-3)mm~2/s).结论 DWI对于预测S2期以上及S3期以上肝纤维化程度具有良好的效果,b值b_(750)、b_(250～1000)或b_(500～1000)均适合慢性病毒性肝炎患者的纤维化评价.
目的 探討MR DWI對肝纖維化程度定量分析的能力.方法 應用1.5 T MR對12名誌願者、47例慢性乙型或丙型肝炎患者進行常規掃描及DWI檢查,b值選擇0、250、500、750及1000 s/mm~2,聯閤b值b_(250～1000)及b_(500～1000)分彆取b=250、500、750和1000 s/mm~2及b=500、750和1000 s/mm~2的ADC平均值.採用Scheuer法進行纖維化(S)分期和炎癥(G)分級,探討病理分期與ADC值的相關性,採用Mann-Whitney U檢驗及Logistic迴歸分析評價ADC預測不同纖維化分期的能力.結果 噹b=750 s/mm~2時,S0、S1、S2、S3、S4期纖維化下ADC平均值分彆為(1.41±0.11)×10~(-3)、(1.37±0.09)×10~(-3)、(1.27±0.05)×10~(-3)、(1.26±0.04)×10~(-3)、(1.22±0.06)×10~(-3)mm~2/s,ADC值在不同S分期間差異最大(F=18.31,P<0.01).隨著S分期的增加,各b值下的ADC平均值逐漸下降,兩者存在負相關性,b_(250～1000)相關性最彊(r=-0.727,P<0.01).選擇b_(750)及b_(250～1000)、b_(500～1000)時,ADC值在S2期以上(與S0和S1相比)及S3期以上(與S0和S1相比)纖維化時均明顯降低(P<0.01);在預測S2期以上纖維化時,選擇b(750)時麯線下麵積(AUC)最大(0.909),敏感性85.7%,特異性100.0%(ADC標準≤1.35×10~(-3)mm~2/s);在預測S3期以上纖維化時,選擇b_(250～1000)時AUC最大(0.864),敏感性69.6%,特異性95.8%(ADC標準≤1.53×10~(-3)mm~2/s).結論 DWI對于預測S2期以上及S3期以上肝纖維化程度具有良好的效果,b值b_(750)、b_(250～1000)或b_(500～1000)均適閤慢性病毒性肝炎患者的纖維化評價.
목적 탐토MR DWI대간섬유화정도정량분석적능력.방법 응용1.5 T MR대12명지원자、47례만성을형혹병형간염환자진행상규소묘급DWI검사,b치선택0、250、500、750급1000 s/mm~2,연합b치b_(250～1000)급b_(500～1000)분별취b=250、500、750화1000 s/mm~2급b=500、750화1000 s/mm~2적ADC평균치.채용Scheuer법진행섬유화(S)분기화염증(G)분급,탐토병리분기여ADC치적상관성,채용Mann-Whitney U검험급Logistic회귀분석평개ADC예측불동섬유화분기적능력.결과 당b=750 s/mm~2시,S0、S1、S2、S3、S4기섬유화하ADC평균치분별위(1.41±0.11)×10~(-3)、(1.37±0.09)×10~(-3)、(1.27±0.05)×10~(-3)、(1.26±0.04)×10~(-3)、(1.22±0.06)×10~(-3)mm~2/s,ADC치재불동S분기간차이최대(F=18.31,P<0.01).수착S분기적증가,각b치하적ADC평균치축점하강,량자존재부상관성,b_(250～1000)상관성최강(r=-0.727,P<0.01).선택b_(750)급b_(250～1000)、b_(500～1000)시,ADC치재S2기이상(여S0화S1상비)급S3기이상(여S0화S1상비)섬유화시균명현강저(P<0.01);재예측S2기이상섬유화시,선택b(750)시곡선하면적(AUC)최대(0.909),민감성85.7%,특이성100.0%(ADC표준≤1.35×10~(-3)mm~2/s);재예측S3기이상섬유화시,선택b_(250～1000)시AUC최대(0.864),민감성69.6%,특이성95.8%(ADC표준≤1.53×10~(-3)mm~2/s).결론 DWI대우예측S2기이상급S3기이상간섬유화정도구유량호적효과,b치b_(750)、b_(250～1000)혹b_(500～1000)균괄합만성병독성간염환자적섬유화평개.
Objective The study was to evaluate DWI for quantifying liver fibrosis. Methods A total of 12 volunteers, 47 patients who had chronic HBV or HCV hepatitis and underwent liver biopsy [Scheuer score for fibrosis(S) and inflammation(G)] were enrolled in this study. They were scanned using a 1.5 T MR unit with b value of 0,250,500,750, 1000 s/mm~2. ADCs at b_(250-1000) and b_(500-1000) were the average ADCs of b=250, 500, 750, 1000 s/mm~2 and b=500, 750, 1000 s/mm~2. The studied the correlation between Scbeuer scores and ADC values, and conducted Mann-Whitney U test and Logistic regression to evaluate ADC for prediction of fibrosis scores. Results The average ADCs were (1.41± 0.11),(1.37±0.09), (1.27±0.05), (1.26±0.04), (1.22±0.06) mm~2/s respectively from SO to S4, stage at b=750 s/mm~2 (F=18.31, P<0.01). With the increase of fibrosis score, the average ADC decreased gradually, the two were better negatively correlated at b_(250-1000)(r=-0.727, P<0.01) than other b values. Using b_(750) and the two combined b values, the found significantly lower ADCs in S2 or greater versus S1 or less and in S3 or greater versus S2 or less fibrosis (P<0.01). The best predictor for S2 or greater was b_(750) with the largest AUC of 0.909, sensitivity of 85.7%, and specificity of 100.0% (ADC ≤1.35×10~(-3) mm~2/s). The best predictor for S3 or greater was b_(250-1000) with the largest AUC of 0.864, sensitivity of 69.6%, and specificity of 95.8% (ADC≤1.53×10~(-3) mm~2/s). Conclusion DWI can be a good predictor for scoring liver fibrosis for S2 or S3 stage above, while b_(750) and the combined b values are suitable for evaluation.
