MRI动态多期增强联合DWI对肝纤维化分期的初步研究

Preliminary study of MRI dynamic multi-phase enhancement combined with DWI on the staging of liver fibrosis

目的探讨磁共振成像(MRI)动态多期增强联合弥散加权成像(DWI)对肝纤维化分期的价值。方法回顾性分析珠海市中西医结合医院2012年3月~2020年12月肝穿刺活检确定病理分级的患者76例。测量肝右叶中b值为600 s/mm^(2)时的表观扩散系数(ADC)值及动态多期图像相对增强(RE)值。比较肝纤维化分期中ADC值与RE值的差异性及其诊断效能,评估ADC值、RE值与肝纤维化之间的相关性。结果ADC值在诊断S0与S2期、S0与S3期中差异有统计学意义(P<0.05)[曲线下面积(AUC):0.831、0.949,灵敏度:86.7%、93.3%,特异度:76.9%、84.6%];门脉晚期的RE值在诊断S1与S2期中差异有统计学意义(P<0.05)(AUC:0.685,灵敏度:62.5%,特异度:69.2%)。ADC值与肝纤维化分期之间存在显著负相关,r值为-0.614(P<0.01),门脉晚期的RE值与肝纤维化分期之间存在弱正相关,r值为0.298(P<0.01)。结论MRI动态多期增强联合DWI对肝纤维化分期的诊断具有一定价值。

Objective To study the value of magnetic resonance imaging(MRI)dynamic multi-phase enhancement combined with diffusion-weighted imaging(DWI)in staging liver fibrosis.Methods A retrospective analysis of 76 patients with liver biopsy to determine the pathological grade from March 2012 to December 2020 in Zhuhai Hospital of traditional Chinese and Western medicine.The apparent diffusion coefficicent(ADC)value and dynamic multi-phase images relative enhancement(RE)values in the right lobe of the liver were measured when the b value was 600 s/mm^(2).Compare the difference between ADC value and RE value in liver fibrosis staging,and its diagnostic efficiency.Evaluate the correlation between ADC value,RE value and liver fibrosis.Results The ADC value is statistically different in the diagnosis of S0 and S2,S0 and S3(P<0.05)[area under the curve(AUC):0.831,0.949,sensitivity:86.7%,93.3%,specificity:76.9%,84.6%];The RE value of the late portal vein is statistically different in the diagnosis of S1 and S2(P<0.05)(AUC:0.685,sensitivity:62.5%,specificity:69.2%).There is a significant negative correlation between ADC value and liver fibrosis stage,r value is-0.614(P<0.01),there is a weak positive correlation between RE value in the late portal vein and liver fibrosis stage,r value is 0.298(P<0.01).Conclusion MRI dynamic multi-phase enhancement combined with DWI has value in the diagnosis of liver fibrosis staging.