[1]李锋,朱桂娟,刘兴祥,等.磁共振ADC值联合GPR模型对CHB肝纤维化的诊断价值[J].徐州医科大学学报,2022,42(05):363-368.[doi:10.3969/j.issn.2096-3882.2022.05.010]
　Diagnostic value of magnetic resonance ADC value combined with GPR model in chronic hepatitis B-related liver fibrosis[J].Journal of Xuzhou Medical University,2022,42(05):363-368.[doi:10.3969/j.issn.2096-3882.2022.05.010]
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磁共振ADC值联合GPR模型对CHB肝纤维化的诊断价值()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
42
期数:
2022年05期
页码:
363-368
栏目:
出版日期:
2022-05-25

文章信息/Info

Title:
Diagnostic value of magnetic resonance ADC value combined with GPR model in chronic hepatitis B-related liver fibrosis
作者:
李锋1; 朱桂娟1; 刘兴祥2; 王华宇3; 张鑫1*
1. 淮安市传染病医院影像科，江苏淮安223000 ；2.淮安市传染病医院检验科，3.南京医科大学附属淮安一院影像科，江苏淮安223000
关键词:
慢性乙型肝炎; 肝纤维化; 磁共振成像; 表观弥散系数; GPR模型
分类号:
R445.2;R512.6+2
DOI:
10.3969/j.issn.2096-3882.2022.05.010
文献标志码:
A
摘要:
目的评估磁共振表观弥散系数（ADC）值联合γ-谷氨酰转肽酶—血小板计数比率（GPR模型）对慢性乙型肝炎（CHB）患者肝纤维化分期的临床诊断价值。 方法选择淮安市传染病医院2016年3月—2021年6月期间完成肝穿刺活检的慢性乙型肝炎患者180例，以2∶1分成训练集和验证集，所有患者均检测磁共振ADC值以及γ-谷氨酰转肽酶（GGT）、血小板计数，并计算GPR模型。以肝纤维化病理分期（F）作为金标准，探讨磁共振ADC值、GPR模型与肝纤维化分期的相关性；应用受试者工作特征（ROC）曲线分析磁共振ADC值联合GPR模型诊断肝纤维化的价值。结果随着肝纤维化程度加重，训练集磁共振ADC值逐渐降低（r=-0.706，P<0.001）；而GPR模型则逐渐升高（r=0.549，P<0.001）。在验证集中，ADC值同样与肝纤维化呈负相关（r=-0.670，P<0.001），GPR模型与肝纤维化呈正相关（r=0.409，P<0.05）。在判断F≥2肝纤维化时，训练集ADC值、GPR模型及二者联合诊断的曲线下面积（AUC）分别为0.855、0.771和0.874，验证集中则分别为0.798、0.705和0.846；在判断F≥3时，训练集AUC分别为0.877、0.802和0.905，验证集中则分别为0.869、0.711和0.906。；而在判断F=4时，训练集AUC分别为0.864、0.778和0.880，验证集中则分别为0.847、0.700和0.868。 结论 磁共振ADC值联合GPR模型可提高慢性乙型肝炎肝纤维化诊断效能，且对于F≥3肝纤维化的诊断最有优势。
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.

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备注/Memo

备注/Memo:
基金项目：2020年江苏省高层次卫生人才“六个一工程”拔尖人才项目（LGY2020059）；中国公共卫生联盟（第一批）课题（GWLM202016）；淮安市自然科学研究计划（HABZ201903）*通信作者,E-mail：973306782@qq.com
更新日期/Last Update: 2022-06-07