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目的:研究MR扩散加权成像(DWI)和CT及MR灌注成像对不同程度肝硬化患者的诊断价值。方法:选择从2015年8月到2017年2月在我院治疗的肝硬化患者60例作为研究对象,根据Child-Pugh分级进行分组,其中A级32例为轻度肝硬化(记为A组),B级16例、C级12例为中重度肝硬化(记为B组),另选同期在我院进行体检的健康志愿者30例记为C组,对三组受试者分别进行DWI检查、CT及MR灌注成像,对比各组ADC值、肝脏动门脉灌注比率[SSr(ct)及SSr(mr)],采用Spearman相关性分析各指标之间的相关性。结果:三组ADC值整体比较无统计学差异(P>0.05),A、B两组的ADC值较C组降低,但差异无统计学意义(P>0.05)。A、B两组的ADC值比较无统计学差异(P>0.05)。三组SSr(ct)、SSr(mr)整体比较,差异有统计学意义(P<0.05),B组的SSr(ct)及SSr(mr)较A、C两组明显升高,差异均有统计学意义(均P<0.05)。A、C两组的SSr(ct)及SSr(mr)比较无统计学差异(P>0.05)。Spearman相关性分析显示,不同程度肝硬化患者的SSr(ct)与SSr(mr)呈正相关(r=0.687,P=0.000)。结论:CT以及MR灌注成像均可较好地反映出肝硬化的病变程度,且二者较DWI成像的诊断效果更佳,值得临床推广。
Objective: To investigate the diagnostic value of MR diffusion weighted imaging (DWI) and CT and MR perfusion imaging in patients with different degrees of liver cirrhosis. Methods: Sixty patients with cirrhosis who were treated in our hospital from August 2015 to February 2017 were enrolled in this study. Patients were divided according to Child-Pugh classification, in which 32 cases of grade A were mild cirrhosis ), Grade B in 16 cases, grade C in 12 cases with moderate-to-severe cirrhosis (marked as group B), and the other 30 cases of healthy volunteers in our hospital during the same period were recorded as group C, and the three groups of subjects were performed The DWI, CT and MR perfusion imaging were performed to compare the ADC value, hepatic portal perfusion rate [SSr (ct) and SSr (mr)], and Spearman correlation analysis was used to analyze the correlation between each index. Results: There was no significant difference in ADC value between the three groups (P> 0.05). The ADC value of A and B groups was lower than that of C group, but the difference was not statistically significant (P> 0.05). There was no significant difference in ADC value between A and B groups (P> 0.05). The SSr (ct) and SSr (mr) of the three groups showed statistically significant difference (P <0.05), while the SSr (ct) and SSr (mr) of group B were significantly higher than those of group A and C Statistical significance (all P <0.05). There was no significant difference in SSr (ct) and SSr (mr) between A and C groups (P> 0.05). Spearman correlation analysis showed that there was a positive correlation between SSr (ct) and SSr (mr) in cirrhotic patients (r = 0.687, P = 0.000). Conclusion: Both CT and MR perfusion imaging can better reflect the degree of cirrhosis. Both of them are more effective than DWI in diagnosis and worthy of clinical promotion.