磁共振扩散加权成像与肝功能MELD评分的相关性研究

Correlation Study of Diffusion Weighted Magnetic Reasonance Imaging and Chronic Type B Hepatitis Staging

目的通过磁共振扩散加权成像(DWI)与肝功能终末期肝病模型(MELD)评分的相关性研究及慢性肝病患者治疗前后的随访研究,探讨磁共振DWI在评价慢性肝病肝储备功能中的应用价值。资料与方法对30名正常自愿者及60例慢性肝病患者行肝脏磁共振DWI(包括15例治疗前后的随访复查),测量并比较正常组与病例组间、治疗前与治疗后间肝实质表观扩散系数(ADC)值,分析标准化ADC值与MELD评分的相关性。结果病例组标准化ADC值较正常组降低(P<0.01),治疗后标准化ADC值较治疗前升高(P<0.01)。b=800s/mm2时,标准化ADC值与MELD评分呈高度负相关,r=-0.70,P<0.01;治疗前后标准化ADC值变化与MELD评分变化也呈显著性负相关,r=-0.61,P=0.017。结论肝实质ADC值与MELD评分高度相关,对慢性乙型肝炎和肝硬化病程演进及疗效观测有较高的临床应用价值,是有效评价慢性肝病肝储备功能的影像学指标。

Objective Investigating the relationship between magnetic resonance diffusion weighted imaging（MR DWI）and model for end stage liver disease （MELD）,and follow up studying of chronic liver disease,so that to investigate the value of DWI in estimating liver functional reserve.Materials and Methods 30 cases of normal volunteers and 60 cases of chronic liver disease patients （including 15 patients follow up for half a year） had undergone magnetic resonance examination.Apparenace diffusion coefficient values（ADCS） of volunteers and patiennts were measured and compared,as well as,ADCS of patients measured before and after treatment were compared.Analyzed the correlation between ADCS and MELD scores.Results ADCS of patients were lower than control group（P0.01）.ADCS of patients gained after treatment was higher than that of before treament（P〈0.01）.When b=800 s/mm2,there was significant negative correlation between patient＇s standardized ADCS and MELD scores （ r=-0.70,P〈0.01）,which was exist before and after treatment.Conclusion There was statistically significant correlation between standardized ADCS and MELD scores.ADCS had high value in observing the clinical course and treatment.Standardized ADCS was a useful imaging indexes in evaluating the hepatic functional reserve.