磁共振弥散加权成像对慢性乙型肝炎肝纤维化程度和炎症活动度的评价

Clinical Value of the Degree of Liver Fibrosis and Inflammation of Hepatitis B by Magnetic Resonance Diffusion Weighted Imaging

目的探讨磁共振弥散加权成像(MR-DWI)在评价慢性乙型肝炎患者肝纤维化程度和炎症活动度方面的应用价值。方法对我院收治的102例慢性乙型肝炎(纤维化组74例,未纤维化组28例)患者和26例健康志愿者(对照组)行MR平扫及DWI检查,设置不同的弥散敏感系数(b)值,测定并比较不同b值时各组表观弥散系数(ADC)值和不同肝纤维化程度及不同炎症活动度的ADC值。结果 b值为100和200s/mm2时,各组ADC值比较差异无统计学意义(P>0.05);b值为400、600和800s/mm2时,肝纤维化组ADC值显著低于未纤维化组(P<0.05);b值为600和800s/mm2时,肝纤维化组S3及S4期ADC值显著低于S0及S1期(P<0.05);b值为100、200和400s/mm2时,不同肝纤维化程度分期ADC值间差异无统计学意义(P>0.05);b值为800s/mm2时,肝炎炎症活动度组G4级ADC值显著低于G1级(P<0.01),不同炎症活动度分级ADC值间差异无统计学意义(P>0.05)。结论 MRDWI在评价慢性乙型肝炎患者肝纤维化程度和炎症活动度方面具有较高的应用价值,且ADC值与肝纤维化程度和炎症坏死程度均密切相关,b值为800s/mm2时效果最佳。

Objective To investigate the Clinical value of the degree of liver fibrosis and inflammation of hepatitis B by MR-DWI. Methods Admitted to our hospital 102 cases of chronic hepatitis B patients （fibrosis group 74 cases and no fibrosis group 28 cases） and 26 healthy volunteers （control group） underwent MR plain scan and DWI examination,set different b values.Determination of and comparison of different b values each ADC values and different hepatic fibrosis degree and different inflammatory activity of ADC value. Results b values of 100 and 200s/mm^2,each ADC value difference was not statistically significant （P〉0.05）;b value of 400,600 and 800s/mm^2,hepatic fibrosis group,ADC values were significantly lower than those without fibrosis group （P〈0.05）;b value of 600 and 800s/mm^2,hepatic fibrosis group S3 and S4 ADC value was significantly lower than that of S0 and S1 （P〈0.05）;b value is 100,200 and 400s/mm^2,different liver fibrosis staging ADC values showed no statistical significance （P〉0.05）;b value of 800s/mm^2,liver inflammation activity group G4 level ADC value was significantly lower than that of the G1 level （P〈0.01）,different inflammation activity grade of ADC value differences had no statistical significance （P〉0.05）. Conclusion DWI in the evaluation of chronic hepatitis B patients with liver fibrosis and inflammation activity degree has a high application value and the ADC values and degrees of hepatic fibrosis and inflammation and necrosis were closely related,the effect is best of b value of 800s/mm^2.