PDF下载 ( 1645 KB)
Value of magnetic resonance morphological imaging in the diagnosis and differentiation of post-hepatitis B cirrhosis
-
摘要: 目的探究MR形态学成像对乙型肝炎肝硬化诊断及鉴别的临床应用价值。方法前瞻性连续纳入2016年7月-2018年4月在兰州大学第一医院住院治疗的乙型肝炎肝硬化患者70例,其中代偿期（CHC） 32例、失代偿期（DHC） 38例,另收集30例健康志愿者为正常对照组。在标准化诊断及分期后,对研究对象行MR常规形态学检查:右叶横径（R1）、右叶矢状径（R2）、左叶横径（L1）、左叶矢状径（L2）、尾状叶横径（W1）、尾状叶矢状径（W2）、肝脏长径L1/R1、L2/R2、门静脉内径、脾静脉内径。计量资料2组间比较采用Mann-Whitney U检验; 3组间比较采用Kruskal-Wallis检验,进一步两两比较采用Mann-Whitney U检验。计数资料组间比较采用χ2检验。采用Spearman等级相关方法分析评价各参数值与不同期肝硬化的相关性。结果 R1、R2、L1、肝脏长径、L1/R1、L2/R2、门静脉内径、脾静脉内径在正常对照组和肝硬化组间比较差异均有统计学意义（U值分别为-5. 54、-5. 76、5. 26、-6. 12、6. 47、5. 08、6. 92、7. 26,P值均<...Abstract: Objective To investigate the value of magnetic resonance (MR) morphological imaging in the diagnosis and differentiation of post-hepatitis B cirrhosis. Methods A prospective study was performed for 70 patients with liver cirrhosis who were consecutively admitted to The First Hospital of Lanzhou University from July 2016 to April 2018, among whom 32 had compensated hepatic cirrhosis (CHC) and38 had decompensated hepatic cirrhosis (DHC) . A total of 30 healthy volunteers were enrolled as normal control group. After standardized diagnosis and staging, MR morphological imaging was performed for all subjects to measure the indices including transverse diameter of the right lobe (R1) , sagittal diameter of the right lobe (R2) , transverse diameter of the left lobe (L1) , sagittal diameter of the left lobe (L2) , transverse diameter of the caudate lobe (W1) , sagittal diameter of the caudate lobe (W2) , long diameter of the liver, L1/R1, L2/R2, diameter of the portal vein, and diameter of the splenic vein. The Mann-Whitney U test was used for comparison of continuous data between two groups; the Kruskal-Wallis test was used for comparison between three groups, and the Mann-Whitney U test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups. Spearman rank correlation was used to investigate the correlation between each parameter and the stage of liver cirrhosis. Results There were significant differences between the normal control group and the liver cirrhosis group in R1, R2, L1, long diameter of the liver, L1/R1, L2/R2, diameter of the portal vein, and diameter of the splenic vein (U =-5. 54, -5. 76, 5. 26, -6. 12, 6. 47, 5. 08, 6. 92, and 7. 26, all P < 0. 05) . There were significant differences in R1, L1, L1/R1, diameter of the portal vein, and diameter of the splenic vein between any two groups of the normal control group, the CHC group, and the DHC group (all P < 0. 05) . There were significant differences between the CHC and DHC groups and the normal control group in R2, long diameter of the liver, and L2/R2 (all P < 0. 05) . R1, R2, and long diameter of the liver were negatively correlated with the progression of liver cirrhosis (r =-0. 604, -0. 554, and-0. 48, all P < 0. 001) , and L1, L1/R1, L2/R2, diameter of the portal vein, and diameter of the splenic vein were positively correlated with disease progression (r = 0. 635, 0. 76, 0. 46, 0. 74, and 0. 42, all P < 0. 001) . Conclusion MR morphological changes are closely associated with the progression of liver cirrhosis and can be used as a basis for the diagnosis and staging of liver cirrhosis.
-
Key words:
- liver cirrhosis /
- hepatitis B /
- magnetic resonance imaging /
- diagnosis
-
[1] VINAIXA C, STRASSER SI, BERENGUER M. Disease reversibility in patients with post-hepatitis C cirrhosis:Is the point of no return the same before and after liver transplantation? A review[J].Transplantation, 2017, 101 (5) :916-923. [2] XU Y, WANG WB, LI ZD, et al. An expert of New 2015 AASLD guidelines for treatment of chronic hepatitis B[J]. J Clin Hepatol, 2016, 32 (2) :223-229. (in Chinese) 徐莹, 王卫彬, 李湛东, 等.《2015年美国肝病学会指南更新版:慢性乙型肝炎的治疗》摘译[J].临床肝胆病杂志, 2016, 32 (2) :223-229. [3] AKINYEMIJU T, ABERA S, AHMED M, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level:Results from the global burden of disease study 2015[J]. JAMA Oncol, 2017, 3 (12) :1683-1691. [4] ROMANELLI RG, STASI C. Recent advancements in diagnosis and therapy of liver cirrhosis[J]. Curr Drug Targets, 2016, 17 (15) :1804-1817. [5] DOHAN A, GUERRACHE Y, BOUDIAF M, et al. Transjugular liver biopsy:Indications, technique and results[J]. Diag Interv Imaging, 2016, 95 (1) :11-15. [6] YAN YQ, MA XS, ZHENG T, et al. Relationship between the change of ratio caudate lobe/right lobe of the liver and diameters in subjects with nonalcoholic fatty liver disease[J]. J Mol Imaging, 2015, 38 (3) :196-199. (in Chinese) 严燕琼, 马显送, 郑韬, 等.肝尾叶与右叶径线及比值变化与非酒精性脂肪性肝病的关系[J].分子影像学杂志, 2015, 38 (3) :196-199. [7] APISARNTHANARAK P, WONGSAWAENG D, MUANGSOMBOON K. Correlation between the severity of hepatitis B cirrhosis and CT volumetry-based hepatic segmental anatomic changes[J]. J Med Asso Thai, 2014, 97 (8) :856-862. [8] PHILIPS P, FARMER RW, SCOGGINS CR, et al. Caudate lobe resections:A single-center experience and evaluation of factors predictive of outcomes[J]. World J Surg Oncol, 2013, 11 (220) :1-6. [9] OZAKI K, MATSUI O, KOBAYASHI S, et al. Morphometric changes in liver cirrhosis:Aetiological differences correlated with progression[J]. Br J Radiol, 2016, 89 (1059) :20150896. [10] NING HB, SHANG J. Association between liver vascular lesions and liver cirrhosis[J]. J Clin Hepatol, 2018, 38 (1) :27-30. (in Chinese) 宁会彬, 尚佳.肝血管病变与肝硬化的关系[J].临床肝胆病杂志, 2018, 38 (1) :27-30. [11] XU YS, LIU HF, LI JK, et al. Value of Gd-EOB-DTPA enhanced MRI in differentlly diagnosing malignant neoplasms from benign nodules of focal liver lesions[J]. Chin J Magn Reson Imaging, 2018, 9 (7) :506-511. (in Chinese) 许永生, 刘海峰, 黎金葵, 等. Gd-EOB-DTPA增强MRI鉴别肝脏良恶性病灶的临床应用价值[J].磁共振成像, 2018, 9 (7) :506-511. 期刊类型引用(6)
1. 严兆兰. 青海地区乙型肝炎肝硬化并发轻微肝性脑病Stroop测试及诱发疾病危险因素调查分析. 中华养生保健. 2024(22): 84-86 . 
百度学术2. 符健，高艺，林锋，李盼盼. 海口地区轻微肝性脑病PHES标准参考值范围的研究. 海南医学. 2023(13): 1903-1907 . 百度学术3. 樊亚楠，纪童童，梁荣月，于岩岩，徐京杭. 肝硬化合并显性肝性脑病危险因素的回顾性分析：一项单中心病例对照研究. 中华肝脏病杂志. 2021(02): 133-136 . 百度学术4. 边倩，解新科，寇小妮，李京涛，魏海梁，闫曙光. 通腑降浊汤联合乳果糖治疗热扰心神型肝性脑病临床观察. 山东中医杂志. 2021(06): 577-582 . 百度学术5. 覃秀容，陈月桥，石清兰，毛德文. 轻微肝性脑病的中西医研究进展. 中医药导报. 2020(12): 152-156 . 百度学术6. 王琳. 疏肝解郁胶囊治疗伴抑郁焦虑的肝性脑病患者的效果. 国际精神病学杂志. 2019(05): 925-928 . 百度学术其他类型引用(1)
-
百度学术
下载:
