MR扩散加权成像和CT及MR灌注成像对不同程度肝硬化患者的诊断价值

目的:研究MR扩散加权成像(DWI)和CT及MR灌注成像对不同程度肝硬化患者的诊断价值。方法:选择从2015年8月到2017年2月在我院治疗的肝硬化患者60例作为研究对象,根据Child-Pugh分级进行分组,其中A级32例为轻度肝硬化(记为A组),B级16例、C级12例为中重度肝硬化(记为B组),另选同期在我院进行体检的健康志愿者30例记为C组,对三组受试者分别进行DWI检查、CT及MR灌注成像,对比各组ADC值、肝脏动门脉灌注比率SSr(ct)及SSr(mr)],采用Spearman相关性分析各指标之间的相关性。结果:三组ADC值整体比较无统计学差异(P0.05),A、B两组的ADC值较C组降低,但差异无统计学意义(P0.05)。A、B两组的ADC值比较无统计学差异(P0.05)。三组SSr(ct)、SSr(mr)整体比较,差异有统计学意义(P0.05),B组的SSr(ct)及SSr(mr)较A、C两组明显升高,差异均有统计学意义(均P0.05)。A、C两组的SSr(ct)及SSr(mr)比较无统计学差异(P0.05)。Spearman相关性分析显示,不同程度肝硬化患者的SSr(ct)与SSr(mr)呈正相关(r=0.687,P=0.000)。结论:CT以及MR灌注成像均可较好地反映出肝硬化的病变程度,且二者较DWI成像的诊断效果更佳,值得临床推广。

Diagnostic Value of MR Diffusion Weighted Imaging and CT and MR Perfusion Imaging in Patients with Different Degrees of Liver Cirrhosis

ABSTRACT Objective: To study the diagnostic value of MR diffusion weighted imaging (DWI) and CT and MR perfusion imaging in patients with different degrees of liver cirrhosis. Methods: A total of 60 patients with liver cirrhosis, who were treated in Ziyang Hospital of West China Hospital of Sichuan University from August 2015 to February 2017 were selected. According to the Child-Pugh classifica- tion, 32 cases of grade A were mild cirrhosis (denoted as group A), 16 cases of grade B and 12 cases of grade C were moderate to severe cirrhosis (denoted as group B), 30 healthy volunteers were selected as group C in the same period. All the subjects in the three groups were examined by DWI, CT and MR perfusion imaging. The ADC value, hepatic portal perfusion ratio SSr (CT) and SSr (MR)] were compared among the three groups, and Spearman correlation analysis was used to analyze the correlation between the indexes. Results: There was no significant difference in ADC values among the three groups (P>0.05), and the ADC values of group A and B were lower than those of group C, but the difference was not statistically significant (P>0.05). There was no significant difference in ADC values be- tween group A and B (P>0.05). The levels of SSr (CT) and SSr (MR) in the three groups were compared, the difference was statistically significant (P<0.05); the levels of SSr (CT) and SSr (MR) in group B were significantly higher than those in group A and C, the differ- ence was statistically significant (P<0.05). There was no significant difference in the levels of SSr (CT) and SSr (MR) in group A and C (P>0.05). Spearman correlation analysis showed that SSr (CT) was positively correlated with SSr (MR) in the patients with liver cirrhosis (r=0.687, P=0.000). Conclusion: CT and MR perfusion imaging can reflect the lesion degree of liver cirrhosis, and diagnostic effects of the two are better than DWI imaging, which is worthy of clinical promotion.