Clinical value of apparent diffusion coefficient in classification of liver fibrosis in chronic liver diseases
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摘要: 目的探讨表观弥散系数(ADC)在定量评估慢性肝病肝纤维化分级中的价值。方法回顾性分析2012年12月-2015年6月珠海市第二人民医院收治的慢性肝病肝纤维化患者63例,根据肝纤维化分期将患者分为5组,S0组(n=24)、S1组(n=18)、S2组(n=10)、S3组(n=6)和S4组(n=5)。所有患者均进行常规磁共振成像扫描及弥散加权成像,测得ADC值。多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Mann-Whitney U检验,相关性分析采用Spearman秩相关分析。结果慢性肝炎肝纤维化分级(S)与ADC值呈负相关(r=-0.389,P<0.001);5组间ADC值比较差异有统计学意义(H=19.904,P<0.001);S0组与S1、S2、S3、S4组ADC值比较,差异有统计学意义(U值分别为18.5、3.0、0、0,P值均<0.05),S1组与S2、S3、S4组ADC值比较,差异有统计学意义(U值分别为129.5、16.5、70.0,P值均<0.05);ADC值在定量评估有无肝纤维化(S≥1)和中重度肝纤维化(S≥2)的曲线下...Abstract: Objective To investigate the clinical value of apparent diffusion coefficient( ADC) in classification of liver fibrosis in chronic liver diseases. Methods A total of 63 chronic liver disease patients with liver fibrosis who were admitted to The Second People's Hospital of Zhuhai from December 2012 to June 2015 were analyzed retrospectively and divided into S0 group( 24 patients),S1 group( 18 patients),S2 group( 10 patients),S3 group( 6 patients),and S4 group( 5 patients) according to the fibrosis stage. All the patients received conventional magnetic resonance imaging scan and diffusion- weighted imaging,and ADC values were obtained. The Kruskal- Wallis H test was applied for comparison between multiple groups,and the Mann- Whitney U test was applied for further comparison between each two groups; the Spearman rank correlation analysis was applied for correlation analysis. Results Classification of liver fibrosis in chronic hepatitis was negatively correlated with ADC( r =- 0. 389,P < 0. 001); ADC showed significant differences between the five groups( H =19. 904,P < 0. 001); ADC value in the S0 group was significantly different from those in the S1,S2,S3,and S4 groups( U = 18. 5,3. 0,0 and 0,respectively,all P < 0. 05); ADC value in the S1 group was significantly different from those in the S2,S3,and S4 groups( U =129. 5,16. 5,and 70. 0,respectively,all P < 0. 05); the areas under the receiver operating characteristic curve for ADC value in quantitative evaluation of no liver fibrosis( S≥1) and moderate- to- severe liver fibrosis( S≥2) were 0. 950 and 0. 799,respectively,with sensitivities of 100% and 77. 8% and specificities of 89. 7% and 85. 7%. Conclusion ADC has a certain clinical value in classification of liver fibrosis in chronic liver diseases.
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Key words:
- liver cirrhosis /
- magnetic resonance imaging /
- apparent diffusion coefficlent /
- diagnosis
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