摘要
目的对比研究不同参照物肝脏标准化表观弥散系数(ADC)值评估肝纤维化病理分期的临床价值。方法以10例健康志愿者和50例经肝穿刺病理证实的慢性肝病患者为研究对象,所有研究对象均进行肝脏弥散加权成像(DWI)检查并测量高b值(b=800s/mm2)肝脏原始ADC值(记为ADC1)、脾脏ADC值、肾脏ADC值、同层竖脊肌ADC值。而后立即对50例患者行肝穿刺活检病理S分期,肝脏ADC值测量区与肝穿刺位点严格一一对应。计算出所有研究对象的肝脏/脾脏标化ADC值(记为ADC2)、肝脏/肾脏标化ADC值(记为ADC3)和肝脏/竖脊肌标化ADC值(记为ADC4)。不同分期间原始或标化肝脏ADC值差异采用单因素方差分析,原始或标化肝脏ADC值与病理S分期相关性采用Spearman等级相关分析法。结果 10例志愿者均为S0期,50名慢性肝病患者按病理S分期分为S1、S2、S3、S4期4组。单因素方差分析提示,b=800s/mm2时,在ADC1、ADC3及ADC4中,不同分期间ADC值差异有统计学意义,且随着纤维化程度加重,ADC值依次递减;在ADC2中,不同分期间ADC值差异则无统计学意义。Spearman等级相关分析法提示,ADC2与病理S分期无相关性,ADC1、ADC3及ADC4与病理S分期存在负相关,其中ADC3与S分期间相关性最好。结论原始肝脏ADC值或肝脏/肾脏/竖脊肌标化ADC值均是评估肝纤维化程度的有效方法,且肝脏/肾脏标化ADC值评价效果优于肝脏/竖脊肌及原始肝脏ADC值。
Objective To compare and research clinical value of standardized apparent diffusion coefficient （ADC） values of the liver on the evaluation of the pathological stage for liver fibrosis. Methods Ten healthy volunteers and 50 patients con- firmed as chronic liver disease by liver biopsy were enrolled as subjects, all of which performed the examination of diffusion weighted imaging （DWI） of the liver, and were assayed on the high b vahles （b=800 s/mm2）, original liver ADC values （deno- ted by ADC1）, spleen ADC values, kidney ADC values, and erector spinae ADC values at the same level Then, liver biopsy was carried out immediately for the pathological staging. The measurement areas of liver ADC values corresponded strictly to liv- er biopsy sites. Standardized liver/spleen ADC values （denoted by ADC2）, standardized liver/kidney ADC values （denoted by ADC3 ） and standardized liver/erector spinae ADC values （denoted as ADC4） were calculated in all subjects. Differences of origi- nal or standardized ADC values of the liver at various staging were analyzed with single-factor analysis of variance. The correlation of original or standardized ADC values of the liver and pathological staging was analyzed by Spearman＇s rank correlation method, respectively. Results Ten volunteers were all in the SO stage, and 50 chronic liver disease patients were divided into S1, S2, S3 and S4 groups based on the pathological staging. Single-factor analysis of variance suggested that differences of ADC values at various staging had statistical significance on the ADC1, ADC3 and ADC4 under b= 800 s/mm2 ; and ADC values de creased in sequence as the aggravation of fibrosis. Differences of ADC values at various staging indicated no statistical signifi canee on the ADC2. No correlation was noticed in the ADC2 and pathological staging; there was negative correlation on the ADC1, ADC3 and ADC4 and pathological staging, in which, the correlation of the ADC3 and pathological staging was the best, as was demonstrated on Spearman＇s rank correlation analysis. Conclusion Original ADC values of the liver or standardized ADC values of the liver/kidney/erector spinae are all effective methods to evaluate the degree of liver fibrosis; and evaluation effects of standardized liver/kidney ADC values are superior to those of ADC values of the liver/erector spinae and original liver.
出处
《福建医药杂志》
CAS
2017年第2期102-105,共4页
Fujian Medical Journal
基金
福州市科技计划项目(2015-S-143-13)
关键词
肝纤维化
磁共振弥散加权成像
表观弥散系数
对比研究
liver fibrosis
magnetic resonance diffusion-weighted imaging （MR DWI）
apparent diffusion coefficient
