Application of magnetic resonance imaging examination in evaluating the severity of liver fibrosis in schistosomiasis
10.3760/cma.j.cn231583-20200413-00083
- VernacularTitle:MRI检查在评估血吸虫病肝纤维化严重程度中的应用
- Author:
Shiyong WU
1
;
Miaomiao HU
;
Mei LI
;
Yinyuan ZHENG
Author Information
1. 湖州市第一人民医院放射科，浙江湖州 313000
- From:
Chinese Journal of Endemiology
2020;39(11):830-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of magnetic resonance imaging (MRI) examination in evaluating the severity of liver fibrosis in schistosomiasis.Methods:A prospective study was carried out to select 50 patients with chronic schistosomiasis admitted to the First People's Hospital of Huzhou City from December 2016 to December 2019 as the observation group, and 35 healthy physical examination subjects during the same period as the control group. All subjects underwent 1.5T MRI scan and diffusion-weighted imaging, and the diffusion sensitivity coefficient (b value) was set to 600 s/mm 2. Using liver biopsy as the gold standard, the degree of liver fibrosis stage was determined. The correlation between apparent diffusion coefficient (ADC), exponential apparent diffusion coefficient (eADC) of diffusion-weighted imaging and liver fibrosis stage was analyzed. And receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic value of ADC and eADC in liver fibrosis of schistosomiasis. Results:Among the 50 patients with chronic schistosomiasis, the MRI scan showed that 39 patients presented with liver lobe proportion imbalance, widened liver fissure, atrophy of right lobe of liver, obvious enlargement of the left outer lobe and caudate lobe of liver; hyperfibrosis and hyperplasia around portal vein leaded to thickening of portal vein wall and appearance of fiber cuff sign; both T1WI and T2WI showed low signals but were not sensitive to late calcification; and there was no obvious change of liver lobe contour and proportion imbalance in other 11 patients. Among them, 7 cases were complicated with liver cancer, and 44 cases were complicated with cholecystolithiasis and cholecystitis. The MRI diffusion-weighted imaging showed that there were statistically significant differences in ADC [(1.17 ± 0.08) × 10 -3, (1.38 ± 0.13) × 10 -3 mm 2/s] and eADC value [(0.51 ± 0.07) × 10 -3, (0.40 ± 0.06) × 10 -3 mm 2/s] between the observation group and the control group ( t = 8.497, 7.762, P < 0.05); and the differences in ADC and eADC values of patients in different liver fibrosis stages in the observation group were statistically significant ( F = 21.526, 23.814, P < 0.05). Correlation analysis results showed that chronic schistosomiasis liver fibrosis was negatively correlated with ADC value ( r = - 0.236, P < 0.05), and positively correlated with eADC value ( r = 0.484, P < 0.05). The ADC value for diagnosing of schistosomiasis liver fibrosis with area under ROC curve (AUC) was 0.826, the 95% confidence interval ( CI) was 0.785 - 0.953, the diagnostic specificity was 89.25%, and the sensitivity was 79.58%; eADC value for diagnosing schistosomiasis liver fibrosis with AUC was 0.681, the 95% CI was 0.582 - 0.879, the diagnostic specificity was 81.14%, and the sensitivity was 73.81%. The ADC and eADC values diagnosed liver fibrosis in S2 - S4 stages were significantly higher in AUC than those in S0 and S1 stages ( P < 0.05), but there was no significant difference between S1 and S0 stages ( P > 0.05). Conclusions:In MRI examination of patients with chronic schistosomiasis liver fibrosis, ADC values decreases significantly, and eADC values increases significantly; and there is a correlation between chronic schistosomiasis liver fibrosis and ADC and eADC values. The ADC and eADC values have certain diagnostic value for schistosomiasis liver fibrosis.
