Abstract: ob＜x＞jective To evaluate the clinical diagnostic value of magnetic resonance apparent diffusion coefficient (ADC) combined with γ-glutamyl transpeptidase/ platelet ratio (GPR) in determining liver fibrosis stages in patients with chronic hepatitis B (CHB). Methods A total of 180 CHB patients who underwent liver biopsy from March 2016 to June 2021 in Huai’an Infectious Disease Hospital were selected. They were divided into a training set and a validation set at a ratio of 2:1. The relationships between magnetic resonance ADC and GPR model with liver fibrosis stages were explored . using the pathological stages of liver fibrosis as the gold standand. The receiver operating characteristic(ROC) curve was plotted to evaluate the combined use of magnetic resonance ADC and GPR model in the diagnosis of liver fibrosis. Results With the aggravation of liver fibrosis, magnetic resonance ADC gradually decreased (r=-0.706, P<0.001), while GPR gradually increased (r=0.549, P<0.001). In the validation set, ADC was negatively related with liver fibrosis (r=-0.670, P<0.001), and GPR was positively related with liver fibrosis (r=0.409, P<0.05). For liver fibrosis with F≥2 for, the area under the curves (AUCs) of the ADC, GPR and their combination were 0.855, 0.771, and 0.874 respectively in the training set, and 0.798, 0.705, and 0.846 respectively in the validation set, For liver fibrosis with F≥3, the AUCs of ADC,GPR model and their combination were 0.877, 0.802, and 0.905 respectively in the training set, and 0.869, 0.711, and 0.906 respectively in the validation set, For liver fibrosis with F=4, the AUCs of ADC,GPR model and their combination were 0.864, 0.778 and 0.880 respectively in the training set, and 0.847, 0.700 and 0.868 respectively in the validation set. Conclusions The combined use of ADC and GPR may improve the diagnostic efficacy of hepatitis B-related liver fibrosis diagnosis, especially for those with F≥3.