The Study Of The Severity Of Hepatic Cirrhosis By 3.0 Tesla Magnetic Resonance Diffusion-weighted Imaging

Part 1 The comparative study on ADC values of the liver in both different Child-Pugh classification hepatic cirrhosis patients and normal volunteers by 3.0 Tesla MR-DWI under different b valuesObjective: To measure the ADC values of the liver in both different Child-Pugh classification hepatic cirrhosis patients and normal healthy volunteers by 3.0 T MR-DWI under different b values, and evaluate its clinical significance.Method:①Hepatic cirrhosis group: Fifty three hepatic cirrhosis patients, included 35 males and 18 females, overall mean age of (55.02±12.56) years, range from 30 to 76 years. The number of Child-Pugh class A, B, C patients were 18, 25, and 10 cases, respectively.②Control group: Thirty normal healthy volunteers, included 18 males and 12 females, with mean age of 55.34±12.68 years, range, from 30 to 79 years. Hepatic cirrhosis group and control group were underwent DWI examination by 3.0 T MRI, 3 groups of b value were used in this study, finally, the ADC value of liver were measured under different b values.Result:1. The ADC value of the left internal lobe of the liver was higher than that of the right posterior lobe in both hepatic cirrhosis group and control group under 3 groups of b value (p<0.05); with the b value increased, ADC value declined; there was significantly statistical difference between different b values in both the left internal lobe and the right posterior lobe of the liver (p<0.05).2. The ADC value of the right posterior lobe of the liver in control group was higher than that in hepatic cirrhosis group under the b value of 500 s/mm2, 800 s/mm2 and 1000 s/mm2, respectively (p<0.05).3. There was significant difference of the ADC values in both liver cirrhosis patients and control group between different b values (p<0.05); there were also significant differences betweent Child-Pugh class A, B, C patients and normal healthy volunteers under the b value of 500 s/mm2, 800 s/mm2 and 1000 s/mm2, respectively (p<0.05); with the Child-Pugh classification increased, ADC value declined.Conclusion: MR-DWI can be used in the quantitative study of hepatic cirrhosis, the ADC value can reflect the severity of hepatic cirrhosis, therefore, DWI can provide a non-invasive and simple research tools for hepatic cirrhosis, and it has very important clinical values.Part 2 The threshold ADC value to diagnose the severity of hepatic cirrhosis by 3.0 Tesla MR-DWIObjective:To measure the ADC values of the liver in both hepatic cirrhosis patients and normal healthy volunteers by 3.0 Tesla MR-DWI, and find the threshold ADC value to evaluate the severity of hepatic liver cirrhosis.Method:①Hepatic cirrhosis group: Fifty three hepatic cirrhosis patients, included 35 males and 18 females, overall mean age of (55.02±12.56) years, range from 30 to 76 years. The number of Child-Pugh class A, B, C patients were 18, 25, and 10 cases, respectively.②Control group: Thirty normal healthy volunteers, included 18 males and 12 females, with mean age of 55.34±12.68 years, range, from 30 to 79 years. Hepatic cirrhosis group and control group were underwent DWI examination by 3.0 T MRI, 3 groups of b value were used in this study, finally, the ADC value of liver were measured under different b values.Result: With the b value of 500 s/mm2 and 1000 s/mm2 to diagnose hepatic cirrhosis of the liver, the sensitivity and specificity was higher than 800 s/mm2, meantime, when using 500 s/mm2, the sensitivity and specificity was higher than 1000 s/mm2. Under b value of 500 s/mm2:1. To determine Child-Pugh class C hepatic cirrhosis, AUC=1.000, 95% CI (1.000-1.000), when ADC=1.365×10-3 mm2/s, the sensitivity and specificity were 100.00% and 100.00%, respectively;2. To determine Child-Pugh class B hepatic cirrhosis, AUC=1.000, 95% CI (1.000-1.000), when ADC=1.405×10-3 mm2/s, the sensitivity and specificity were 100.00% and 100.00%, respectively;3. To determine Child-Pugh class A hepatic cirrhosis, AUC=0.937, 95% CI (0.870-1.004), when ADC=1.500×10-3 mm2/s, the sensitivity and specificity were 88.90% and 93.3%, respectively;4. To determine Child-Pugh class A,B,C hepatic cirrhosis, AUC=0.979, 95% CI (0.954-1.003), when ADC=1.500×10-3 mm2/s, the sensitivity and specificity were 96.2% and 93.30%, respectively.Conclusion: The threshold ADC value in MR-DWI shows a great value in the evaluation of the severity of hepatic cirrhosis.