| Objective: according to the change of ADC value in right anterior lobe and right posterior lobe after food in-take, to evaluate the effect of hemodynamic change caused by food in-take and different ROI on hepatic DWI; To observe the changes of the ADC value of patients in different grade of fibrosis, and analyze it's correlation with pathologic result, and then to evaluate the value of DWI in staging of liver fibrosis; To observe the changes of the CTP parameters of patient in different grade of fibrosis, and analyze it's correlation with pathologic result, then compare them with the results of DWI research, to evaluate the diagnostic value of DWI and CTP in staging of liver fibrosis.Materials and methods: 23 healthy volunteers (male 18, female 5,averaged age 36.3) underwent DWI examination fasting for 8 hours and 1 hour after taking standard meal, the b values for DWI were 200 s/mm2, 500 s/mm2and 700 s/mm2. The ADC values of right anterior lobe and right posterior lobe under different b value were measured respectively. Paired t test was used to compare the ADC value of fasting and postprandial, and also was used to compare the ADC value of right anterior lobe and right posterior lobe. 57 patients with hepatic fibrosis (male 18,female 5,averaged age 38.6, S1～S4 is 21,16,17,3 respectively ) and 23 control group (male 18, female 5,averaged age 36.3) underwent DWI (b=500 s/mm~2) . The ADC value of different fibrosis stage and different inflammatory stage, the ROI were placed in right posterior lobe, about 1 cm. analysis of variance was used to compare the difference among all the groups. 36 patients with liver fibrosis(male 25,female 11,averaged age 41.5 ) and 23 control group (male 18, female 5,averaged age 36.3) underwent dynamic spiral CTP. CTP parameters including hepatic blood flow(BF), blood volume(BV), hepatic arterial fraction(HAF), mean transit time(MTT), permeability surface(PS) were obtained through liver perfusion analysis software. analysis of variance was used to compare the difference among all the groups, ROC curve was used to analyze the sensitivity and specificity of DWI and CTP.Result: when b value was 200 s/mm2, the postprandial ADC value of right anterior lobe and right posterior lobe both increased obviously (P =0.000, 0.001) ; when b was 500 s/mm~2 and 700 s/mm~2, the postprandial ADC value of right anterior lobe increased obviously (P=0.001, 0.003) , but that of right posterior lobe did not change (P =0.110, 0.076) . When fasting, the difference of ADC value between right anterior lobe and right posterior lobe were not significant (P=0.324, 0.163, 0.854) , but it was significant after food in-take(P=0.030, 0.036, 0.033). The difference of ADC value between control group and S1 group was not significant, that between control group and S2,S3,S4 group was significant (Pe =0.000,0.000,0.000) , that between S2 group and S3 group , S3 group and S4 group , S3 group and S4 group was significant (P =0.006,0.000,0.003) . The difference of ADC value between G0 group and G2,G3,G4 group were significant (P =0.001,0.002,0.008) ,that between G1 group and G2,G3,G4 group were significant (P =0.013,0.010,0.027) ;HAF between control group and S3-4 group were different (P =0.004) , the sensitivity and specificity of DWI and CTP was 78.9%, 82 .6% and 66.67%, 73.91% respectively.Conclusion: The ADC value of right posterior lobe is more precise than right anterior lobe, which is the best location for the measure of ADC value. 500 s/mm~2 is the best b value for the measurement of ADC value in hepatic DWI examination. DWI can reflect the change of liver fibrosis earlier than traditional imaging, S2,S3,S4 group can be distinguished according to the change of ADC value, and ADC value can reflect the degree of inflammation roughly. ADC value can be used as an important index for the early diagnosis of liver fibrosis. HAF can distinguish control group and S3-4 group. DWI is the best examination for the diagnosis and stage of fibrosis.
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