慢性乙型肝炎肝功能损害的DWI初步研究

Evalution of Liver Function Injury in Patients with Chronic Hepatitis B by Diffusion Weighted MR Imaging:Preliminary Experience

目的:探讨弥散加权成像在无创性评价慢性乙型肝炎患者肝功能损害程度中的临床价值。方法:17例慢性乙型肝炎患者,其中男13例,女4例,年龄26～77岁,平均年龄42.29岁。以11例无肝病病史的正常成人作为正常对照组,其中男3例,女8例,年龄34～71岁,平均年龄45.5岁。对慢性乙型肝炎患者肝脏弥散加权成像中肝实质ADC值和eADC值与血清ALT、AST、PA、TBIL生化指标进行相关性分析。结果:当b=500s/mm2时,慢性乙型肝炎平均ADC值[(0.959±0.093)×10-3mm2/s]低于正常对照组[(1.141±0.086)×10-3mm2/s],而慢性乙型肝炎平均eADC值(0.38±0.501)高于正常对照组(0.312±0.033);两组之间差异均具有统计学意义(P值均<0.05)。慢性乙型肝炎平均ADC值与ALT、PA及TBIL具有较好的相关性[-0.530(P<0.05),0.740(P<0.05),-0.593(P<0.05)],而ADC值与AST之间没有相关性。慢性乙型肝炎平均eADC值与PA、TBIL之间具有较好的相关性[-0.771(P<0.05),0.572(P<0.05)],而eADC值与ALT、AST之间均没有相关性。结论:DWI在一定程度上可以反映慢性乙型肝炎肝功能损害程度,DWI中ADC值在无创性评价慢性乙型肝炎肝功能损害中具有一定的临床意义。

Purpose： To explore the value of MR diffusion weighted imaging in the assessment of liver function injury in patients with chronic hepatitis B. Methods： Seventeen patients （man 13, women 4, mean age 42.29years） with chronic hepatitis B and 11 healthy controls （man 3, women 8, mean age 45.5years） underwent liver diffusion weighted imaging （DWI） by using b values of 0 and 500s/mm2. The liver ADC value and eADC value of choric hepatitis B patients and healthy controls were compared. The correlation of serum liver function biochemical indicators（ALT, AST, PA, TBIL） with ADC value, and eADC value was analyzed respectively. Results：The mean ADC values were （0. 959 ± 0. 093） x 10-3mm2/s and （1. 141 ± 0. 086） x 10-3mm2/s for hepatitis B patients and control subjects, respectively. The mean eADC values were 0.38 ＋ 0.501 and 0.312 ＋ 0.033 for hepatitis B patients and control subjects, respec tively. When b = 500s/mm2 was used, the differences of ADC and eADC values between choric hepatitis B patients and control subjects were statistically significant（P 〈 0.05） . For the patients with choric hep atitis B, the correlation coefficients of ADC vaules and ALT, AST, PA, TBIL were - 0. 530（P 〈 0.05）, - 0. 351（P 〉 0.05）, 0. 740（P 〈 0.05）, and - 0. 593（P 〈 0.05）, respectively. There were statistically correlation between ALT, PA, TBIL and ADC. The correlation coefficients of eADC vaules and ALT,AST, PA, TBIL were 0. 370（ P 〉 0.05）, 0. 275（P 〉 0.05）, - 0. 771（P 〈 0.05）, and 0. 572（P 〈 0.05）, respectively. There was statistically correlation between PA, TBIL and eADC.Conclusion： DWI may be used to e valuate the liver function injury under choric hepatitis B, and ADC value has important clinical signifi cance in the noninvasive evaluation of liver function damage under chronic hepatitis B.