| Objective To investigate the Intravoxel incoherent motion imaging?IVIM?I in evaluating quantitatively the application value of the degree of liver fibrosis.Methods Collected 69 patients confirmed by pathology of liver fibrosis by 3.0 T GE Signa HDx scanners for IVIM scanning in January 2016-January 2018 in our hospital,and compared with 20 cases of healthy volunteers in the same condition with normal liver function,measure the slow/true diffusion coefficient D value,fast/pseudo diffusion coefficient D*value,filling fraction f value and apparent diffusion coefficient of ADC values by Functool post-processing software.According to the pathological staging of fibrosis group cases,the experimental group is divided into early stage?S1?,medium?S2+S3 period?,late stage?S4?.Liver fibrosis group and control group data conform to normal distribution,the comparison of parameters between the two groups using independent sample t test,analyse the parameter value of different degree of fibrosis with the single factor analysis of variance in the experimental group,data compared in the group using the LSD test.By spearman correlation analysis,analyse the correlation between the IVIM parameters and different stages of fibrosis in the experimental group,and finally uses the receiver-operating characteristic curve?ROC curve?to calculate and analyse statistically significant IVIM parameter test efficiency for different fibrosis group differences.P<0.05 for the difference was statistically significant.Results 69 cases of hepatic fibrosis patients contain 18 cases of early stage,mid-stage by25 cases?11 cases in S2,14 cases in S3?,26 cases in late stage D*,D and f value have statistically significant in difference between liver fibrosis group and control group,?P<0.05?,the difference of ADC values are no statistically significant.The D value of the control group and experimental group are?0.95±0.08?×10-3mm2/s and?0.80±0.26?×10-3mm2/s respectively,D*are?9.98±2.39?×10-2mm2/s and?4.35±6.95?×10-2mm2/s,respectiely,f value are?0.54±0.14?and?0.34±0.14?mm2/s respectiely.The comparison of differences of D*and f value in liver fibrosis are statistically significant,as the degree of fibrosis aggravating,D*and f value showed a trend of gradual decline,both in the liver fibrosis of the early,middle and late 3 period are?8.73±12.30?×10-2mm2/s and?0.43±0.15?mm2/s,?4.65±1.68?×10-2mm2/s and?0.34±0.16?mm2/s,?1.03±5.80?×10-2mm2/s and?0.27±0.08?mm2/s respectively?The compared difference of D value in early and late stage are statistically significant,the value of three stages are?0.93±0.29?×10-3mm2/s,?0.78±0.22?×10-3mm2/s,?0.73±0.24?×10-3mm2/s respectively.D,D*and f value is negatively related to the liver fibrosis stage respectively presented low,moderate negative correlation,moderate negative correlation relationship,The correlation coefficient are-0.29,-0.44,-0.43 respectively?P<0.05?.D*and f value for early diagnosis of liver fibrosis area under the ROC curve are 0.83,0.68,and D*have the higher efficiency than f value in the diagnosis of early diagnosis of liver fibrosis.When D*threshold value 0.087,the sensitivity and specificity corresponding to 75%and 89%.D*and f value for?medium diagnosis of liver fibrosis area under the ROC curve are 0.92,0.83,and D*have the higher efficiency than f value in the diagnosis of?medium diagnosis of liver fibrosis.When D*threshold value 0.053,the sensitivity and specificity corresponding to 84%and82%.Conclusion IVIM parameter?D,D*and f?has certain value for diagnosis of liver fibrosis,D*and f value can reflect the degree of liver fibrosis,roughly D*in the diagnosis of early and?medium diagnosis of liver fibrosis has higher efficiency,to provide a valuable reference for early clinical evaluation quantitative degree of liver fibrosis. |
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