3.0T磁共振扩散加权成像技术无创评估肝硬化分级

Evaluation of cirrhotic staging and hepatic function with noninvasive MR diffusion weighted imaging at 3.0 Tesla

目的:探讨不同b值表观扩散系数(ADC)值、指数化表观扩散系数(eADC)值以及灌注ADC值和eADC值在肝硬化分级及肝功能损害评估方面的价值。方法:对53例肝硬化患者肝脏进行DWI扫描,并计算低(100 s/mm2、200 s/mm2和300 s/mm2)、中(400 s/mm2和600 s/mm2)和高(800s/mm2、1 000 s/mm2和1 200 s/mm2)b值时肝组织的ADC值和eADC值,然后根据低、高b值时ADC和eADC值的差异计算灌注ADC和eADC值。分析DWI各测量参数与Child-Pugh分级及与临床肝功能血清检测指标之间的关系。结果:低b值ADC值、中b值的ADC和eADC值以及灌注ADC值在Child-Pugh分级之间均见统计学差异(P<0.05),其余测量值未见统计学差异(P>0.05)。低b值ADC值与AST负相关(P=0.040,r=-0.554),中b值ADC值分别与TP、ALB正相关(P=0.006,r=0.814;P=0.034,r=0.570),但与GLO负相关(P=0.017,r=-0.601),灌注ADC值也与AST负相关(P=0.021,r=-0.643),其余参数之间均未见相关性(P>0.05)。结论:利用DWI技术可对肝硬化的程度进行分级,ADC值相关参数也可在一定程度上反映肝硬化时肝功能情况。

Objective： To probe the value of evaluating in hepatic function in cirrhosis and the Child-Pugh staging using the apparent diffusion coefficient（ADC）,exponential apparent diffusion coefficient（eADC）,the perfusion ADC（ADCperf） and perfusion eADC（eADCperf） values with different b values.Methods： Noninvasive magnetic resonance diffusion weighted imaging（DWI） was carried out in 53 cirrhotic patients.The ADC value and eADC value with low（100s/mm2,200s/mm2 and 300s/mm2）,moderate（400s/mm2 and 600s/mm2） and high（800 s/mm2,1000 s/mm2 and 1 200 s/mm2） b values were analyzed on hepatic parenchyma.According to the difference in ADC and eADC values between low b value and high one,the perfusion ADC（ADCperf） and perfusion eADC（eADCperf） values were calculated.The relationship of ADC and eADC parameters with Child-Pugh staging and some serum markers of hepatic function were analyzed.Results： The statistic differences in the ADC value with low b value,the ADC and eADC values with moderate b value,and ADCperf value were seen among Child-Pugh stags（P0.05）.A negative correlation of the ADC value with low b value with AST was found（P=0.040,r=-0.554）.The positive correlations of the ADC value with moderate b value with TP and ALB were also identified（P=0.006,r=0.814;P=0.034,r=0.570）,whereas the correlation with GLO was reverse（P=0.017,r=-0.601）.The ADCperf value was negatively related to AST（P=0.021,r=-0.643）.No relationships were identified between other parameters above（P0.05）.Conclusion： DWI can be used for the liver cirrhosis staging,and the ADC parameters may reflect the hepatic function in cirrhosis to some degrees.