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肝脏弥散加权成像临床应用价值初步分析-影像医学与核医学专业论文
上海交通大学医学院
上海交通大学医学院 2002 级七年制硕士研究生学位论文
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PAGE 4
The CLI NI CAL EVALUATI ON OF DI FFUSI ON WEI GHTED MR I MAGI NG I N LI VERS: PRELI MI NARYM
STUDY
ABSTRACT
Purpose: This study was designed to find out the characteristic of diffusion weighted MRI (DWI) in normal persons and liver fibrosis patients through the DWI exams, and also to assess the clinical feasibility of evaluating liver fibrosis by measuring the apparent diffusion coefficients (ADCs) and ascertain the accuracy in staging of the liver fibrosis and cirrhosis (F0-F6).
Materials and methods: 77 patients (mean age 29.27±6.62 years) with histological proven liver fibrosis by liver biopsy and 37 healthy controls (mean age 46.97±16.56 years) underwent liver diffusion-weighted imaging (24 liver fibrosis patients underwent DWI again one year later) with different b values: b=0, 200, 500, 1000s/mm2. ADCs, SNR and image quality of diffusion-weighted images were measured respectively.
Result: (1)There was no statistical difference of the ADC values of
normal liver in different ages or genders(p0.05). The ADC values of liver left lobe was obviously larger than that of right lobe, and the ADC values of liver right VII, VIII lobe was obviously larger than that of right V, VI lobe. The ADC values(10-3mm2/s) of normal liver were 2.36±0.14(range: 2.15 -
2.60,b=200 s/mm2), 1.59±0.10(1.48 - 2.37,b=500 s/mm2), 1.48±0.25(1.42
- 1.76,b=1000 s/mm2). (2)With the increase of fibrosis stage, the ADC values decreased;And there had negative correlation between fibrosis stages and ADC values. As b=500 and 1000s/mm2, the mean ADCs were significantly lower in advanced stage of liver fibrosis (F≥3) comparing with those of controls and early stage of liver fibrosis (p0.05), which could not be found as b=200s/mm2. For b=500 s/mm2, the ADC threshold for advanced liver fibrosis (F≥3) was 1.695 (10-3mm2/s) with an area under the receiver operating characteristic(ROC) curve of 0.888, a sensitivity of 77.8% and a specificity of 87.
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