MR弥散成像监测核苷类药物治疗活动性乙型肝炎前后肝脏ADC值变化

Monitor ADC value changes in liver before and after receiving nucleoside analogue antiviral treatment in patients with active hepatitis B virus using diffusion-weighted magnetic resonance imaging value of apparent diffusion coefficient in liver cirrhosis

目的探讨采用MR弥散加权成像监测核苷类药物治疗活动性乙型肝炎前后肝脏ADC值变化的意义。方法 26名经临床诊断活动性乙型肝炎患者治疗前和接受核苷类药物治疗后6个月后行MRI并测量肝实质ADC值。采用t检验比较治疗前后ADC值差异和Pearson相关分析比较治疗前后ADC差值与III型前胶原氨基端肽(PIIINP)、透明质酸(HA)、甘氨胆酸(CG)治疗前后差值的相关性,P<0.05认为有统计学意义。结果 26名活动性乙型肝炎患者治疗前肝实质ADC值为(1.619±0.161)×10-3 mm2/s低于治疗后的(1.842±0.160)×10-3 mm2/s,两者差异有统计学意义(t=6.608,P=0.000)。治疗前后ADC差值为(0.222±0.172)×10-3 mm2/s,PIIINP差值的均数为(51.886±22.957)ng/ml,HA差值的均数为(21.345±13.584)ng/ml,CG差值的均数为(12.830±15.962)ug/dl。活动性乙型肝炎经核苷类药物治疗前后肝脏ADC差值与III型前胶原氨基端肽(PIIINP)差值及透明质酸(HA)差值的相关性(r分别为0.614和0.413,P值分别为0.001和0.036),而与甘氨胆酸(CG)差值的相关性无统计学意义(r=0.318,P=0.114)。结论MR弥散加权成像测量肝脏ADC值可结论MR弥散加权成像测量肝脏ADC值可以作为评价核苷类药物治疗活动性乙型肝炎疗效的手段。以作为评价核苷类药物治疗活动性乙型肝炎疗效的手段。

Objective To investigate value of monitoring ADC value changes in liver before and after receiving nucleoside analogue antiviral treatment in patients with active hepatitis 13 virus using diffusion-weighted magnetic resonance imaging. Methods 26 patients with active hepatitis B virus underwent MRI before and after receiving nucleoside analogue antiviral treatment for six months. ADC value was measured. The different of liver ADC value before and after receiving nucleoside analogue antiviral treatment was compared by t test and relationship between difference value of ADC and difference value of PIIINP, HA and CG was analyzed using Pearson. Results Hepatic ADC value was 1. 619 ±0. 161） ×10-3mm2/s and （1. 842±0. 160）×10-3mm2/s before and after receiving nucleoside analogue antiviral treatment respectively. The difference was statistical significant （ t =6. 608, P =0. 000）. The difference value of ADC, PIIINP, CG and HA was （0. 222± 0. 172） ×10-3mm2/s, （51. 886± 22. 957） ng/ml, （21. 345 ±13. 584） ng/ml and （12. 830 ± 15. 962） ug/dl, respectively. The different value of ADC was related to that of PIIINP and CG with statistical significant, and was not related to that of CG. Conclusion Diffusion imaging of MR can be used as an efficient modality to monitor therapy effect of nucleoside analogue in in patients with active hepatitis B virus.