本文選題：肝臟 + 纖維化　； 參考：《臨床放射學(xué)雜志》2015年09期

【摘要】：目的探討肝臟表觀擴(kuò)散系數(shù)(ADC)值在慢性肝炎活動(dòng)度分級(jí)和肝纖維化分期中的臨床應(yīng)用價(jià)值。方法對(duì)符合納入標(biāo)準(zhǔn)的55例慢性病毒性肝炎患者和28名正常人進(jìn)行肝臟MR擴(kuò)散加權(quán)成像(DWI)檢查,b值選取0,600 s/mm2,并重組相應(yīng)ADC圖。在MR檢查后1~5天內(nèi),病例組行肝穿刺活檢術(shù)或肝臟病變切除術(shù)。肝穿刺活檢在超聲引導(dǎo)下進(jìn)行,記錄穿刺點(diǎn)所在肝段及對(duì)穿刺點(diǎn)進(jìn)行標(biāo)記;肝臟手術(shù)病例取病變周?chē)母谓M織做肝纖維化病理檢查,并記錄取材點(diǎn)在大體標(biāo)本上的空間位置,測(cè)量取材點(diǎn)與肝臟病變間的距離。利用Imagej圖像處理軟件對(duì)肝臟ADC值進(jìn)行測(cè)量并記錄。病例組肝臟ADC值測(cè)量時(shí)感興趣區(qū)(ROI)的位置根據(jù)穿刺點(diǎn)或手術(shù)標(biāo)本取材點(diǎn)的空間結(jié)構(gòu)信息進(jìn)行設(shè)置。病例組按肝纖維化程度將患者分為S1~S4四組,按肝臟炎癥活動(dòng)度將患者分為G1~G4四組。對(duì)不同G分級(jí)、S分期之間的肝ADC值進(jìn)行統(tǒng)計(jì)分析,并對(duì)G分級(jí)、S分期與肝ADC值進(jìn)行相關(guān)分析。運(yùn)用受試者工作特性曲線(ROC)評(píng)估肝ADC值預(yù)測(cè)≥S1期、≥S2期及≥S3期纖維化的效能。結(jié)果肝臟ADC值隨著G分級(jí)及S分期的增高而減低,G分級(jí)及S分期與肝臟ADC值之間均具有良好的負(fù)相關(guān)(r=-0.741,P=0.000及r=-0.708,P=0.000)。肝臟ADC值能區(qū)分正常組與S1~S4各組(P0.05)、≥S2與S2期纖維化(P0.05)、正常組與G1~G3各組(P0.05)、G1組與G2、G3組(P0.05)。肝臟ADC值診斷≥S1、≥S2、≥S3期纖維化的曲線下面積(AUC)、敏感性及特異性均較高,相應(yīng)閾值分別為1.29×10-3mm2/s、1.27×10-3mm2/s、1.24×10-3mm2/s。結(jié)論肝臟ADC值對(duì)慢性肝炎活動(dòng)度分級(jí)和肝纖維化分期的診斷具有一定的敏感性與特異性,對(duì)肝纖維化早期診斷及慢性肝炎癥活動(dòng)度評(píng)估有一定的參考價(jià)值。
[Abstract]:Objective to evaluate the clinical value of ADCC in the classification of chronic hepatitis activity and hepatic fibrosis. Methods 55 patients with chronic viral hepatitis and 28 normal controls were examined by Mr diffusion weighted imaging (DWI) of liver, and 0600 s / m ~ (-2) were selected and the corresponding ADC map was recombined. Within 1 ~ 5 days after Mr examination, liver biopsy or hepatectomy were performed in the case group. Liver biopsy was conducted under the guidance of ultrasound to record the location of the puncture site and the marking of the puncture site. The liver tissue around the lesion was taken for pathological examination of liver fibrosis in the liver operation case, and the space position of the sampling point on the gross specimen was recorded. The distance between the sampling point and the liver lesion was measured. The ADC value of liver was measured and recorded by Imagej image processing software. The location of the region of interest (ROI) was set according to the spatial structure information of the puncture point or the sampling point of the operation specimen in the case group when the ADC value of the liver was measured. Patients in the case group were divided into S1~S4 group and G1~G4 group according to the degree of hepatic fibrosis. The ADC value of liver was statistically analyzed among different G / S stages, and the correlation between G / S staging and liver ADC value was also analyzed. The effectiveness of liver ADC value in predicting fibrosis in 鈮，

本文編號(hào)：1953804