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目的探讨胆囊壁水肿的MRI特征及评估慢性乙肝病理变化的价值。资料与方法慢性乙肝67例,正常18例。扫描序列包括T1WI、T2WI、快速采集稳态进动梯度回波(FIESTA)及动态增强扫描。观察有无胆囊壁水肿及其厚度。结果胆囊壁水肿12例,平均厚度为(5.68±3.78)mm。中度慢性肝炎(G3)、重度慢性肝炎(G4)各6例。各组间胆囊壁水肿出现率差异有统计学意义(P=0.000)。G3、G4间差异无统计学意义(P=0.729)。轻度组与中重度组间差异有统计学意义(P=0.000),正常组与中重度组间差异有统计学意义(P=0.005)。各组间胆囊壁水肿厚度差异无统计学意义(t=1.255,P=0.252)。肝纤维化各组(S0～S4)内胆囊壁水肿出现率差异无统计学意义(P=0.124)。胆囊壁水肿预示中重度慢性肝炎的敏感性33.33%,特异性100%。结论 MRI能敏感地显示胆囊壁水肿。胆囊壁水肿提示慢性乙肝中重度炎症活动,具有较高特异性。
Objective To investigate the MRI features of gallbladder wall edema and evaluate the value of chronic hepatitis B pathological changes. Materials and Methods Chronic hepatitis B 67 cases, 18 cases of normal. Scanning sequences include T1WI, T2WI, fast acquisition of FIESTA, and dynamic contrast-enhanced scan. Observe gallbladder wall edema and its thickness. Results The gallbladder wall edema in 12 cases, the average thickness of (5.68 ± 3.78) mm. Moderate chronic hepatitis (G3), severe chronic hepatitis (G4) in 6 cases. The incidence of gallbladder wall edema in each group was significantly different (P = 0.000). There was no significant difference between G3 and G4 (P = 0.729). There was significant difference between mild group and moderate-severe group (P = 0.000), there was significant difference between normal group and moderate-severe group (P = 0.005). There was no significant difference in gallbladder wall edema between groups (t = 1.255, P = 0.252). The incidence of gallbladder wall edema in each group (S0 ~ S4) of liver fibrosis had no statistical difference (P = 0.124). Gallbladder wall edema indicates that the sensitivity of moderate to severe chronic hepatitis is 33.33% and the specificity is 100%. Conclusion MRI can show gallbladder wall edema sensitively. Gallbladder wall edema prompts chronic hepatitis B moderate to severe inflammatory activity, with high specificity.