Clinical Study On Quantitative Diagnosis Of Hepatic Fibrosis Based On Magnetic Resonance Of DKI And BOLD

[Objective]To explore the application value of multi-parameters quantization of DKI and BOLD in diagnosing hepatic fibrosis.[Materials and methods]10 healthy volunteers and 53 liver surgery or liver puncture surgery patients in our hospital were included in our study.Preoperative MRI scan was performed to obtain conventional sequences、DKI and BOLD images.The average of the MD、MK and R2*values were measured as liver quantitative parameters from post-processing images.Postoperative liver tissues were collected for liver fibrosis pathological stage.One way anova was used to compare the differences of the values of each quantitative parameter under different stages of liver fibrosis and inflammatory activity.Pairwise comparison in the group was performed by LSD method.Non-parametric Spearman test was used to analyze the correlation quantitative parameters and the pathological stage and inflammatory of liver fibrosis.The independent influencing factor of each parameter were analyzed by multiple regression.ROC curve was used to distinguish the sensitivity and specificity of each parameter in the diagnosis of liver fibrosis of different grades.P<0.05 was considered statistically significant.[Results]10 volunteers were in the non-fibrosis group with stage S0,and 53 of the patients received liver tissue for liver fibrosis stage after surgery,and obtained stage S1-S4:12,11,13,17cases.MD value decreased gradually with the increase of the liver fibrosis degree,and the two were negatively correlated(r=-0.812,P<0.001).The differences and pairwise comparison between S0,S 1+2 and S3+4 groups were statistically significant(F=32.115,P<0.001).MK value was positively correlated with liver fibrosis stage(r=0.949,P<0.001).The differences and pairwise comparison between S0,S 1+2 and S3+4 groups were statistically significant(F=49.657,P<0.001).R2*value was positively correlated with liver fibrosis stage(r=0.908,P<0.001).The differences and pairwise comparison between S0,S1+2 and S3+4 groups were statistically significant(F=34.002,P<0.001).MD value was negatively correlated with inflammatory activity(r=-0.706,P<0.001).MK value was positively correlated with inflammatory activity(r=0.814,P<0.001).R2*value was positively correlated with inflammatory activity(r=0.756,P<0.001).Compared with inflammatory activity,liver fibrosis stage was an independent factor in determining the value of each parameter(P<0.001).Among MD、MK、MD+MK and MD+MK+R2*,the AUC under ROC for the diagnosis of hepatic fibrosis stage S0-2 vs S3-4 were 0.988,1.000,0.982,1.000 and 1.000 respectively.The sensitivity were all 1.000,and the specificity were 0.970,0.970,0.879,1.000 and 1.000.[Conclusion]MD、MK and R2*multi-parameters can be used to quantify the diagnosis of liver fibrosis.The combined diagnosis efficiency of MD and MK is also high,and the combination of the three parameters is the best in the diagnosis of liver fibrosis at each stage.DKI and BOLD can provide an important basis for clinical non-invasive evaluation of liver fibrosis.