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弥散加权 MRI 评估慢性活动性肝炎患者肝纤维化的价值。

Utility of diffusion-weighted MRI for assessing liver fibrosis in patients with chronic active hepatitis.

机构信息

Department of Gastroenterology, Bakirköy Training and Research Hospital, Istanbul, Turkey.

出版信息

Diagn Interv Radiol. 2010 Sep;16(3):204-8. doi: 10.4261/1305-3825.DIR.2810-09.1. Epub 2010 Jul 25.

DOI:10.4261/1305-3825.DIR.2810-09.1
PMID:20658448
Abstract

PURPOSE

We evaluated the utility of quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) for assessing both the relationship between the degree of fibrosis and the histological activity index (HAI) in chronic hepatitis (CH) cases and attempted to determine whether the apparent diffusion coefficient value (ADC) could be used as a reference for the degree of fibrosis detected by histology.

MATERIALS AND METHODS

The study population consisted of 55 CH patients (Group I) and a control group of 30 volunteers (Group II). Group I consisted of 31 CH-B (CHB), 18 CH-C (CHC) and 6 non-alcoholic steatohepatitis patients. DW-MRI of the liver with b values of 0, 500 and 1000 s/mm(2) was performed, and liver biopsies of the patients were obtained two weeks later. The ADC value, degree of liver fibrosis and HAI were compared within Group I, and the ADC values of both groups were compared with each other.

RESULTS

The ADC was lower in Group I than in Group II (P < 0.05). The ADC of the left lobe lateral (LL) (P < 0.05), left lobe medial (LM) and right lobe anterior (RA) segments (P < 0.01) in Group I were lower than those of Group II. There was no relationship between HAI and the ADC of LL, LM, RA and right lobe posterior (RP) segments in Group I. Additionally, there was no correlation between fibrosis scores and ADC in Group I, whereas there was a negative correlation between fibrosis scores and ADC values of the LL (28.3%) and RP (29.5%).

CONCLUSION

CH patients had lower ADC values. There was no correlation between ADC values and fibrosis stages or ADC and HAI values. Quantitative DW-MRI was not useful in determining the degree of fibrosis in liver tissue.

摘要

目的

我们评估了定量扩散加权磁共振成像(DW-MRI)在评估慢性肝炎(CH)病例纤维化程度与组织学活动指数(HAI)之间关系的效用,并尝试确定表观扩散系数值(ADC)是否可作为组织学检测纤维化程度的参考。

材料和方法

研究人群包括 55 例 CH 患者(I 组)和 30 名志愿者对照组(II 组)。I 组包括 31 例 CH-B(CHB)、18 例 CH-C(CHC)和 6 例非酒精性脂肪性肝炎患者。对肝脏进行 b 值为 0、500 和 1000 s/mm2 的 DW-MRI,两周后对患者进行肝活检。在 I 组内比较 ADC 值、纤维化程度和 HAI,并比较两组的 ADC 值。

结果

I 组的 ADC 值低于 II 组(P < 0.05)。I 组的左叶外侧(LL)(P < 0.05)、左叶内侧(LM)和右叶前(RA)段的 ADC 值低于 II 组(P < 0.01)。I 组中,HAI 与 LL、LM、RA 和右叶后(RP)段的 ADC 之间没有关系。此外,I 组中纤维化评分与 ADC 之间没有相关性,而纤维化评分与 LL(28.3%)和 RP(29.5%)的 ADC 值之间存在负相关。

结论

CH 患者的 ADC 值较低。ADC 值与纤维化分期或 ADC 与 HAI 值之间没有相关性。定量 DW-MRI 对确定肝组织纤维化程度没有帮助。

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