| Objective: Diffusion weighted imaging(DWI) combined with laboratory tests-four indexes of hepatic fibrosis were used to analyze the pathological stages of hepatic fibrosis,which is of great significance for early,timely and accurate diagnosis of hepatic fibrosis,early intervention,prevention and treatment of the disease,as well as the blocking and delaying the progression of the disease.Materials and methods: hepatic fibrosis patients in our hospital from February 2011 to February 2015 a total of 54 cases of hepatitis B were retrospectively analyzed,the liver DWI b value of the sequence images of =600s/mm2800s/mm2,application of GE postprocessing workstation AW4.4 Function software image processor,in close proximity to the region for ROI measurement of liver biopsy,ROI diameter of about 10 mm or so round,taking the average ADC three times the measured value;liver biopsy using classification standard in 2000 Xi'an conference "repair viral hepatitis prevention and control plan > made on hepatic fibrosis,liver fibrosis will be divided into five F0-F4,and on the basis of the results of the pathological staging,the detection results of four groups,combined with the clinical liver serum fibrosis,using SPSS18.0 software for statistical analysis,measurement data among groups were compared using single factor analysis of variance,such as the overall difference was statistically difference,using LSD 22 Spearmann method was used to analyze the correlation of two variables,and the area of the curve,sensitivity and specificity were used to evaluate the efficiency of ROCResults:1.Pathological results:Liver tissue samples were obtained by liver biopsy,and were stained by MASSON and HE in two ways.The results showed that 12 people in stage S0,14 people in stage S1,11 people in stage S2,7 people in stage S3,and 10 people in stage S4.2.ADC value:(1)when the value of B =600s/mm2,S0 ADC=2.15 + 0.10,S1 + 0.26ADC=2.02 S2 + 0.20,ADC=1.74,S3,ADC=1.69 + 0.08,S4 + 0.10 ADC=1.60,ADC value was negatively correlated with liver fibrosis(P<0.01,r=-0.755);when the value of B =800s/mm2,S0ADC=1.57.0.06 S1,ADC=1.45 + 0.18,S2 + 0.12 ADC=1.33 S3 + 0.07,ADC=1.25,S4,ADC=1.16 + 0.16,ADC value was negatively correlated with liver fibrosis(P<0.01,r=-0.759).(2)When the value of B =600s/mm2,S0 ADC=2.15 + 0.10,S1 + 0.26 ADC=2.02 S2 + 0.20,ADC=1.74,S3,ADC=1.69 + 0.08,S4 + 0.10 ADC=1.60;when the b value of =800s/mm2,S0,ADC=1.57 + 0.06,S1 + 0.18 ADC=1.45 S2 + 0.12,ADC=1.33,S3 ADC=1.25.0.07,S4ADC=1.16 + 0.16.(3)under different b value of liver fibrosis ADC values in each phase of the 22 comparison result shows,when the value of B =600 s/mm2,S0 and S2,S3,S4,S1 and S2,S3,S4 and S2 and S4 diffusion weighted imaging ADC values were statistically significant differences(P<0.05),but the S0 and S1 phase,S2 phase and S3 phase,the ADC value and between S3 and S4 phase difference was not statistically significant(P>0.05);when b=800 s/mm2,S0 and S1,S2,S3,S4,S1 and S2,S3,S4,S3 and S4 during the period diffusion weighted imaging ADC value difference was statistically significant(P<0.05),ADC value between S2 only and S3 phase difference was not statistically significant(P>0.05)(4)By ROC curve method to explore the value of ADC for hepatic fibrosis,when b=600s/mm2,ROC area under curve was 0.877,sensitivity,specificity and Youden index were100%,65.9%,0.659;b=800s/mm2 =0.957,the area under ROC curve,sensitivity,specificity,and Youden index was 90%.In 95.5%,0.855.in 800 is the area under the Roc curve of more than 600 visible both have high sensitivity and specificity in the diagnosis of liver fibrosis,but the b value of =800s/mm2,sensitivity and specificity than the b value of =600s/mm2 is higher.3.The correlation between serum fibrotic indexes and four liver fibrosis staging and ADC value:(1)analyze the correlation analysis showed that the clinical data of 54 patients of different stages:the stage of liver fibrosis and liver fibrosis serum four indicators(HA,PCIII,CIV,LN)and the correlation coefficients were 0.852,0.704,0.720,0.603,and were statistically significant(P<0.001).(2)liver fibrosis staging and ADC correlation analysis results showed that when b=600s/mm2,ADC value and four indexes of liver fibrosis serum(HA,PCIII,CIV,LN)and the correlation coefficients were-0.649,-0.451,-0.490,--0.287,were statistically significant(P<0.05)when the b value =800s/mm2,ADC value of the correlation coefficient and four indexes of liver serological(HA-0.694,PCIII-0.753,CIV-0.735,LN-0.632).(3)of the serum liver fibrosis stage HA,LN and PC III 22 indicators of comparative analysis,the The difference between the two groups was statistically significant.There was no significant difference in the serum C-IV markers of liver fibrosis in S1 and S2 phase(P>0.05),but the C-IV index of S3 and S4 was statistically significant(P<0.05)?Conclusions:1.The ADC value of diffusion weighted imaging decreased with the severity of liver fibrosis,and showed a significant negative correlation2.The value of B =600 s/mm2,by measuring the ADC value of the liver in differential diagnosis of S0 and S2,S3,S4,S1 and S2,S3,S4,S2 and S4 phase has high clinical value,but the S0 and S1 phase,S2 phase and S3 phase,and between S3 and S4 stage the diagnosis still has great limitation;but when the value of B =800 s/mm2,by measuring the ADC value of the liver in differential diagnosis of S0 and S1,S2,S3,S4,S1 and S2,S3,S4,S3 and S4 phase has high clinical value,only between S2 and S3 differential have limitations,so the b values in the diagnosis of =800s/mm2 is more suitable for clinical detection of levels of liver fibrosis.3.Liver fibrosis serum four indicators are positively correlated with the degree of liver fibrosis.ADC value and four indexes of liver fibrosis(HA,PCIII,serum CIV,LN)was negatively correlated with the degree of liver fibrosis value,more weight,the lower the ADC value,the four indexes of serum hepatic fibrosis is higher.4.Serum HA,LN and PC markers of liver fibrosis can provide a high clinical help in the differential diagnosis of liver fibrosis,but the diagnostic value of C-IV is limited,it is difficult to identify the S1 and S2 phase of hepatic fibrosis in patients with liver fibrosis in III5.Diffusion weighted magnetic resonance imaging ADC values reflect the progress and serum fibrotic liver fiber four better disease and high on hepatic fibrosis diagnosis and differential diagnosis of the value of the clinical application,should be considered as a noninvasive imaging method is worthy to be popularized. |
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