对比分析磁共振成像T_2值和ADC值用于慢性肝病定量诊断的临床价值

Contrastive analysis of clinical values of MRI T_2 and ADC values used in quantitative diagnosis of chronic liver disease

目的分析探讨磁共振成像(MRI)T2值和表观扩散系数(ADC值)用于评价不同程度慢性肝病的临床意义。方法选取经肝穿刺活检确诊的40例肝炎、肝纤维化患者为观察组,另外选取同期来体检的40例健康人作为对照组。两组研究对象通过常规MRI扫描测量T2值和磁共振弥散加权成像扫描(MR-DWI)测量肝脏组织ADC值。以肝穿刺病理对照为金标准,对比T2值和ADC值在肝脏纤维化不同分期的变化情况,分析它们之间的相关性。结果对照组和观察组中不同炎症活动分期和纤维化分期、病情轻重的磁共振成像T2值和ADC值的差异有统计学意义(P<0.05),观察组中随着炎症活动分期和纤维化分级别的升高和病情的加重,T2值和ADC值相应降低和升高;T2值与病理诊断结果呈明显正相关(P<0.05),ADC值与病理诊断结果呈明显的负相关(P<0.05)。结论 MRI T2值和ADC值能够较早评估慢性肝病的纤维化分期和炎症活动度,为临床提供无创、快捷、准确的定量诊断方法,可作为慢性肝病抗病毒、抗纤维化药物治疗的辅助评估手段。

Objective To analyze and investigate the clinical significance of the MRI T2 values and apparent diffusion coefficient（ADC）values for evaluating the different degrees of chronic liver disease.Methods 40 patients with hepatitis and liver fibrosis diagnosed by the liver biopsy in our hospital were selected as the observation group and contemporaneous 40 healthy people undergoing the physical examination were selected as the control group.The T2 values in the two groups were measured by the conventional MRI scanning and the live tissue ADC values were measured by the diffusion weighted magnetic resonance imaging scans（MR-DWI）.The correlation between the T2 values and ADC values was analyzed.Results The T2 values and ADC values in different inflammatory activity stages,fibrosis stages and illness severities had statistically significant differences between the observation and the control group（P〈0.05）,with the elevation of inflammatory activity stages and fibrosis stages,and illness deterioration,the T2 values and ADC values in the observation group were correspondingly reduced and increased;the T2 values were positively correlated with the pathological diagnosis results（P〈0.05）,while the ADC values were negatively correlated with the pathological diagnosis results（P〈0.05）.Conclusion MRI T2 values and ADC values can early assess the fibrosis staging and inflammatory activity of chronic liver disease,provides a noninvasive,fast and accurate quantitative diagnostic method for clinic,and can serve as an auxiliary assessment means of anti-virus,anti fibrosis medication therapy of chronic liver disease.