Study Of DWI And CTPI In Liver Cirrhosis Diagnosis And Classification

Objective:To observe the changes of the ADC value in liver cirrhosis patients with different Child-pugh grades, and evaluate the value of DWI in staging of liver cirrhosis; To observe the changes of the CT perfusion parameters in liver cirrhosis patients with different Child-pugh grades, and evaluate the value of CTPI in staging of liver cirrhosis. Then we compare their diagnostic capacity to find the superior method in grading with liver cirrhosis.Materials and methods:Thirty-five liver cirrhosis patients after classification according to the Child-pugh (male22, female13, aged from35-76, averaged age55)underwent DWI examination, the b values for DWI were200s/mm2,500s/mm2and800s/mm2. Single factor variance analysis was used to compare the ADC values of Child-pugh groups. Least significant difference test would be appled when variance was same and the different was statistically significant among the groups, and Dunnett-t3test would be used when variance was not same and the different was statistically significant among the groups. CT perfusion were underwent by these35patient meanwhile to obtain the the parameters of CTPI, including blood flow (BF), blood volume (BV), mean transit time (MTT), hepatic arteria fraction (HAF) and permeability surface (PS). Single factor variance analysis was used to compare the parameters. Least significant difference test would be appled when variance was same and the different was statistically significant among the groups, and Dunnett-t3test would be used when variance was not same and the different was statistically significant among the groups. Comparing the result of DWI and CTPI by drowing ROC curve with SPSS13.0software, to find the best examination in grading with liver cirrhosis.Result:The difference of ADC value between Child-pugh groups was significant when b=200s/mm2, and500s/mm2, and the difference was not significant when b=800s/mm2,. Compare them eachother, we will find the ADC values differences of liver cirrhosis between Child a-class and b-class, c-class were statistically significant, and the difference between b-class and c-class was not statistically significant when b=200s/mm2, When b=500s/mm2, the ADC values differences of liver cirrhosis with all different Child classification groups were statistical significant. In the parameters of CTPI, only the difference of HAF between three groups was statistical significant, BF、BV、MTT and PS were not statistical significant. The difference of HAF were significant among all Child-pugh groups. Because only ADC (b=500s/mm2) and HAF were significant among all Child-pugh groups, so drowing ROC curve with these two.It showed the AUC of ADC was0.892,beyond the AUC of HAF.Conclusion:1.ADC of DWI can reflect the degree of liver cirrhosis, so it can be used in liver cirrhosis classification.500s/mm2is the best b value for the measurement of ADC value in hepatic DWI examination for1.5T MRI.2. HAF of CTPI can reflect the degree of liver cirrhosis, so it can be used in liver cirrhosis classification.3. DWI is slightly superior to CTPI for the diagnosis and classification of liver cirrhosis, and is the ideal method of liver cirrhosis diagnosis and classification currently.