Application Of Diffusion Weighted Imaging In Inflammation Activity Of Chronic Hepatitis B

Purpose: To study the correlation between ADC values of diffusion weighted imaging(DWI) and the pathological gradings in inflammation activity of chronic hepatitis b, and combine with conventional MRI features to predict the diagnosis effectiveness.Materials and Methods: 142 cases of patients with chronic hepatitis B were selected as inflammatory group in our hospital from January 2014 to December 2015, while 20 cases of healthy subjects without history of liver disease were chosen as control group. All cases were performed MR plain scan and dynamic contrast enhancement and DWI examinations(b=0,800s/mm ) for liver, and performed liver biopsy within two days. According to the degree of inflammation activity (G), the inflammation group was divided into G1, G2 and G3-4 level. Measure the apparent diffusion coefficient (ADC) value, and the MRI features of each group were analyzed, then the data was statistically analyzed.Results: The ADC values showed statistically significant (F=8.392, P<0.001) within inflammation group of chronic hepatitis b from different pathologic grading, and there was significant negative correlation between ADC values and liver inflammation activity grading (r=0.462, P<0.001). The ADC value of inflammation group and control group was 1.31±0.16?1.12±0.15, there was statistical significance (P<0.05) between them. The ADC value of G1?G2 and G3-4 level was 1.22±0.12?1.05±0.12?0.98±0.10 respectively, and there was statistical significance (P<0.05) between G1 and G2?G1 and G3-4. The receiver operating characteristic curve (ROC) in diagnosis of equal and above G2 level showed the area under the curve (AUC) was 0.880, the sensitivity and the specificity was 88.4% and 76.8% respectively, the diagnostic cut-off value was 1.13.Besides, the detection rate of portal around its orbit and gallbladder wall edema in inflammation group had significant difference (P<0.05), and there was no significant difference (P>0.05) in the detection rate of abnormal liver arterial enhancement, hilus lymph node increases and ascites in inflammation group. The ROC in diagnosis of equal and above G2 level by ADC values combined with the MRI characteristic signs showed AUC was 0.938, the sensitivity and the specificity was 88.4% and 88.9% respectively.Conclusion: ADC values can predict the inflammation activity of chronic hepatitis b with quantitatively and non-invasively, and combining with characteristic MRI imaging signs can improve the diagnosis efficiency.Objective: To study the correlation between the pathology classification of the chronic hepatitis b and the parameters of IVIM.Materials and Methods: 220 patients of chronic hepatitis b with clinical diagnosis were performed IVIM-DWI of liver with 11 b values (0-1000s/mm ), and 20 healthy volunteers as control group performed with liver DWI scan at the same time. The ADC values, D, D*values, and f were calculated at GE image post-processing workstation. According to the degree of inflammation activity (G), the inflammation group was divided into G1, G2 and G3-4 level. The differences of ADC, D, D*, and f in different inflammation activity classification were analyzed, and the correlations of IVIM parameters and hepatitis inflammation activity gradings were respectively analyzed by Spearman test. The diagnose efficiency in differentiation of inflammation activity were performed with ROC analysis.Result: The ADC?D?D *?f values between control group and inflammation group respectively was (1.322±0.09×10-3mm2/s, 1.19±0.11×10-3mm2/s),(0.86±0.17×10-3mm2/s,0.77±0.19×10-3mm2/s),(128.2±32.3±10-3mm2/s,105.3±37.6×10-3mm2/s),(34.1± 8.9%,27.5 ± 8.7%),and the differences were statistically significant. The values of ADC, D *, f in inflammation group of different pathological gradings were statistically significant(P<0.05), and the ADC values(r = -0.377, P = 0.001),D* values( r = - 0434, P = 0.001),and f values( r = -0.226, P = 0.003)were all negatively correlated with the differentiation of inflammation activity, while D values had no correlation with the pathological differentiation of inflammation activity( r =-0.076, P = 0.138) . For equal and above G2 grade inflammation activity, the area under the ROC curve (AUC) was 0.735, 0.748, 0.837 respectively, diagnostic sensitivity and specificity were 85.5%?48.3%,55.7%?87.2%,75.4%?81.6%. F value in the diagnosis of G3-4 or higher level of inflammation activity area under the ROC curve (AUC) was 0.600,sensitivity and specificity were 69.8%?51.3% respectively.Conclusion: The ADC values?D* values and f were negatively correlated with differentiations of inflammation activity of hepatitis b, and the ADC values combined with D* values had better diagnostic performance in diagnosis of G2 and higher levels of inflammation activity.