| Objective: To show the portal system and it's collateral clearly with the LAVA technology of 3.0T magnetic resonance imaging. To investigate relation between the diameter of portal and the degree of liver function impairment. Evaluation the relation between left gastric vein dilation and the risk of upper gastrointestinal bleeding in liver cirrhosis. To probe the ADC value diversification in liver cirrhosis and which faction affect it.Methods: The study cases include 20 volunteers and 48 patients with cirrhosis. Group of patients with cirrhosis were divided into A, B and C levels by the Child-Pugh classification. Using the LAVA of SIGNA EXCITE3.0 GEHCGEHC technique in two groups undergoing upper abdominal examination,and using the maximum intensity projection (MIP) in ADW 4.3 workstation to display the portal and measure its diameter. Diffusion weighted imaging was performed in 48cirrhotic patients and 20healthy controls (control group) at SIGNA EXCITE3.0 GEHCGEHC when b value was 800s/mm.The ADC value in each liver segments was measured and analyzed on Function2 software.Results: The cirrhotic nodules were showed clearly by 3.0Tesla magnetic resonance. In 48 cirrhotic patients, could discover 36 patients with cirrhotic nodules, which show include big nodules/small nodules and mixed nodules.48 cirrhotic patients and 20 volunteers'portal and left gastric vein show clearly. In the cirrhotic patients group, could discover 34 patients with lateral branch opening at varying degree.With liver function damaged deepening, the portal diameter gradually thickening has statistically significant (p<0.05). The Child-Pugh B C class group diameter of LGV is noticeably wider than the Child-Pugh A class group and normal group, the Child-Pugh A class group diameter of LGV is noticeably wider than the normal group (p<0.05). Left gastric vein diameter in the upper gastrointestinal bleeding group widened than the non-bleeding group (p<0.05); In the cirrhosis group,when LGV diameter≥6mm,the risk of upper gastrointestinal bleeding will increase(p<0.05).The value of each liver segment in cirrhotic group was lower than in healthy group, except the liver caudate lobe, from normal volunteers to liver function Child-Pugh C class group, the liver lobes ADC values become smaller significantly(p<0.05).But there is no significant difference between Child-Pugh A class group and Child-Pugh B class group.Conclusion:1 The different cirrhosis nodules show different signal characteristics on the different sequence of MRI, which can analyze the signal characteristics to judge the cirrhosis nodules are malignant or not. 2 Combining the LAVA technology and the powerful post-processing software, can clearly show the shape of portal vein, branch and the blood vessels around the relationship, with the advantages are high safety, no radiation and small amount contest agent. 3 According to dates that portal vein show small variation. The left gastric vein origin show large variation, which originate in portal vein, splenic vein or their confluence. 4 In the cirrhosis patients group, the LGV, portal vein and its tributaries'diameter are thicker than the volunteers. With Child-Pugh classification of cirrhosis liver gradually increase from the volunteer group to the Child-Pugh B C class group, the each diameter also gradually thickening, in other words, Child-Pugh B C class group>Child-Pugh A class group>volunteer group. 5 when the diameter of LGV in patients with cirrhosis greater or equal to 6mm, cases of upper gastrointestinal bleeding increased significantly, can put the left gastric vein diameter of 6mm as a predictor of the critical value of upper gastrointestinal bleeding. 6 Except the caudate lobe, the lobes of cirrhosis ADC value is smaller than normal volunteers, and with the deepening of liver cirrhosis, the ADC value gradually decrease, so we can use the value to evaluate the degree of cirrhosis fibrosis objectively. |
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