CAJ | 학술논문

　　目的观察MR扩散加权成像(DWI)和超声瞬时弹性成像(Fi-broscan， FS)对肝纤维化的诊断价值，并对二者的诊断能力进行对比研究。材料与方法35例肝纤维化患者及21名健康志愿者(正常对照组)接受DWI (b1=0 s/mm2, b2=600 s/mm2)检查，并测量ADC值；其中33例患者及正常对照组接受超声瞬时弹性成像，将FS检查中获取的10次成功检查所得的弹性硬度值(Stiffness)作为FS指标。对测量结果行单因素方差分析及两两比较，并绘制ROC曲线比较两者对肝纤维化诊断的敏感度和特异度。结果弹性硬度值随纤维化分期从S0~S4期逐步升高，而ADC值依次降低(P值均＜0.05)。正常对照组及肝纤维化S1组与肝纤维化S2、S3、S4组间差异均有统计学意义。MR DWI与FS诊断肝纤维化的敏感度分别为79.40%和86.33%，而特异度分别为83.60%，76.91%。结论 FS对肝纤维化的敏感度高于DWI，而MR DWI对肝纤维化的特异度优于FS，二者结合应用是目前肝纤维化早期诊断及分级的最佳检查手段。
　　목적관찰MR확산가권성상(DWI)화초성순시탄성성상(Fi-broscan， FS)대간섬유화적진단개치，병대이자적진단능력진행대비연구。재료여방법35례간섬유화환자급21명건강지원자(정상대조조)접수DWI (b1=0 s/mm2, b2=600 s/mm2)검사，병측량ADC치；기중33례환자급정상대조조접수초성순시탄성성상，장FS검사중획취적10차성공검사소득적탄성경도치(Stiffness)작위FS지표。대측량결과행단인소방차분석급량량비교，병회제ROC곡선비교량자대간섬유화진단적민감도화특이도。결과탄성경도치수섬유화분기종S0~S4기축보승고，이ADC치의차강저(P치균＜0.05)。정상대조조급간섬유화S1조여간섬유화S2、S3、S4조간차이균유통계학의의。MR DWI여FS진단간섬유화적민감도분별위79.40%화86.33%，이특이도분별위83.60%，76.91%。결론 FS대간섬유화적민감도고우DWI，이MR DWI대간섬유화적특이도우우FS，이자결합응용시목전간섬유화조기진단급분급적최가검사수단。
Objective:Comparative study the diagnostic value of diffusion weighted imaging (DWI) and Fi-broscan(FS)in diagnosis of liver fibrosis. Materials and Methods:Thirty-ifve hepatic ifbrosis patients and 21 normal controls received DWI (b1=0s/mm2, b2=600s/mm2), ADC value of different fibrosis stages was measured, while 33 patients and all 21 normal controls received FS. The elastic stiffness value (stiffness) achieved in 10 successful FibroScan examinations was taken as Fi-brosan index. Analysis of variances was performed to compare the difference among the groups in both examinations. ROC curve was used to analyze the sensitivity and speciifcity of DWI and FS. Results:The value of stiffness was gradually increased from the liver fibrosis stage S0 to S4, while the mean ADC value decreased as the severity of liver ifbrosis increased(P<0.01). Between control group and S1, S2, S3, S4 group and among group S2, group S3, group S4 was signiifcant. Sensitivity of DWI and FS was 79.40%and 86.33%. Speciifcity of DWI and FS was 83.60%and 76.91%. Conclusions: Sensitivity of FS is higher than DWI, while specificity of DWI is superior to FS. Therefore, the application both DWI and FS is the best examinational method for early diagnosis and de-grading of liver ifbrosis.