University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, 40225 Duesseldorf, Germany.
Magn Reson Imaging. 2013 Sep;31(7):1092-6. doi: 10.1016/j.mri.2013.01.003. Epub 2013 Jun 2.
The purpose of this study was to assess the influence of liver cirrhosis and portal hypertension on diffusion coefficients of the spleen.
We retrospectively evaluated 50 patients with liver cirrhosis and 50 patients without any history of liver disease who underwent magnetic resonance imaging of the upper abdomen, including echo planar diffusion-weighted imaging using b values of 50, 300 and 600mm(2)/s. Spleen apparent diffusion coefficient (ADC), liver ADC, muscle ADC and normalized spleen ADC (defined as the ratio of spleen ADC to muscle ADC) were compared between cirrhotic patients and patients in the control group and correlated with Child-Pugh stages. Reproducibility was assessed by measuring interclass correlation coefficient (n=11). Additionally, in eight patients, ADC measurements were performed 1 day before and 3 days after transjugular intrahepatic portosystemic shunt (TIPSS) implantation.
Compared with control subjects, patients with cirrhosis and portal hypertension had significantly higher spleen ADCs (P=.0001). There was a statistically significant correlation between Child-Pugh grade and spleen ADC (Pearson correlation coefficient, observer 1 r=0.6, P=.0001; observer 2 r=0.5, P=.0001). After TIPSS implantation, we observed a reduction in spleen ADC values. Spleen ADC measurements showed a high reproducibility (interclass correlation coefficient 0.75, P=.001).
Our data suggest that different stages of liver cirrhosis and portal hypertension correlate with ADC values of the spleen. Furthermore, ADC values of the spleen decrease after TIPSS implantation. Further studies are required to understand the potential clinical values of these observations.
本研究旨在评估肝硬化和门静脉高压对脾脏扩散系数的影响。
我们回顾性评估了 50 例肝硬化患者和 50 例无肝脏疾病史的患者，所有患者均行上腹部磁共振成像检查，包括使用 b 值为 50、300 和 600mm²/s 的平面回波扩散加权成像。比较肝硬化患者和对照组患者的脾脏表观扩散系数（ADC）、肝脏 ADC、肌肉 ADC 和标准化脾脏 ADC（定义为脾脏 ADC 与肌肉 ADC 的比值），并与 Child-Pugh 分期相关。通过测量组内相关系数（n=11）评估重复性。此外，在 8 例患者中，在经颈静脉肝内门体分流术（TIPSS）植入前 1 天和植入后 3 天进行 ADC 测量。
与对照组相比，肝硬化伴门静脉高压患者的脾脏 ADC 明显升高（P=.0001）。Child-Pugh 分级与脾脏 ADC 之间存在统计学显著相关性（Pearson 相关系数，观察者 1 r=0.6，P=.0001；观察者 2 r=0.5，P=.0001）。TIPSS 植入后，我们观察到脾脏 ADC 值降低。脾脏 ADC 测量具有较高的可重复性（组内相关系数 0.75，P=.001）。
我们的数据表明，不同阶段的肝硬化和门静脉高压与脾脏的 ADC 值相关。此外，TIPSS 植入后脾脏 ADC 值降低。需要进一步的研究来了解这些观察结果的潜在临床价值。
