MR扩散加权成像对肝纤维化的诊断价值及其与CT灌注成像的比较研究
摘要
研究目的:比较肝扩散加权成像中不同b值条件下正常人进食前后肝右前叶及右后叶ADC值的变化,以此来评价血流灌注改变以及不同的测量区域对ADC值的影响;观察不同肝纤维化分级病人ADC值的变化,及与相应病理结果的相关性,评价DWI在肝纤维化分级中的价值;观察不同肝纤维化分级病人CT灌注参数的改变,评价CT灌注成像对肝纤维化的诊断能力,并将结果与第二部分MR扩散加权成像的研究结果做比较研究。
研究方法:23例受试者(男性18例,女性5例,平均年龄为36.3岁)于禁食8小时及标准餐后1小时分别行DWI检查,b值选择为200 s/mm~2,500 s/mm~2及700 s/mm~2。分别测量餐前餐后各b值条件下右前叶及右后叶ADC值。对两叶进食前后ADC值进行配对t检验,观察进食对两叶ADC值的影响;对进食前后两叶ADC值进行配对t检验,比较不同饮食状态下两叶ADC值有无差别。对57例肝纤维化病人(其中男性43例,女性14例,平均年龄为38.6岁,肝纤维化S1-S4分别为21例,16例,17例,3例)及23例对照组(男性18例,女性5例,平均年龄为36.3岁)进行DWI(b值为500 s/mm~2)检查,ADC值测量过程中,圆形兴趣区放置于右后叶,直径约为1cm。将测得的不同纤维化分级及炎症分级的ADC值进行单因素方差分析,方差齐且组间差别有统计学意义者,采用SNK-q检验进行方差分析及两两比较;方差不齐且组间差别有统计学意义者,采用Dunnett-t3检验进行方差分析及两两比较。对36例肝纤维化病人(其中男性25例,女性11例,平均年龄为41.5岁)及23例对照组(男性18例,女性5例,平均年龄为36.3岁)进行CT灌注检查,用肝灌注分析软件取得不同肝纤维化分级病人肝实质的灌注参数,包括BF,BV,MTT,HAF,PS。将测得的参数进行单因素方差分析,方差齐且组间差别有统计学意义者,采用SNK-q检验进行方差分析及两两比较;方差不齐且组间差别有统计学意义者,采用Dunnett-t3检验进行方差分析及两两比较。对57例肝纤维化病人的MR扩散加权成像研究结果和36例肝纤维化病人的CT灌注成像研究结果进行比较,通过Medcalc统计软件绘制ROC曲线比较两者对肝纤维化诊断的敏感性和特异性。
结果:b值为200 s/mm~2时右前叶及右后叶餐后ADC值均明显增加,差别有统计学意义(P值分别为0.000,0.001);b值为500 s/mm~2及700 s/mm~2时,右前叶餐后ADC值明显增加,差别有统计学意义(P值分别为0.001,0.003),右后叶餐后ADC值的改变无统计学意义(P值分别为0.110,0.076)。餐前各b值条件下右前叶与右后叶ADC值差别无统计学意义(P值分别为0.324,0.163,0.854);餐后各b值条件下右前叶及右后叶ADC值差别均有统计学意义(P值分别为0.030,0.036,0.033)。
正常对照组与肝纤维化S1组间ADC值差别无统计学意义,与肝纤维化S2,S3,S4组间差别均有统计学意义(P值均为0.000);肝纤维化S1组与S2,S3,S4组间差别均有统计学意义(P值均为0.000);肝纤维化S2与S3,S4组间差别有统计学意义(P值分别为0.006,0.000);肝纤维化S3与S4组间差别有统计学意义(P值为0.003)。G0组与G2,G3,G4各组间ADC值差别有统计学意义(P值分别为0.001,0.002,0.008),G1组与G2,G3,G4组间ADC值差别有统计学意义(P值分别为0.013,0.010,0.027)。
BV、BF、MTT、PS在各组间差别无统计学意义。HAF在正常对照组与纤维化较重组(S3-4组)间差别有统计学意义(P值均为0.004)。两种成像方法的比较研究结果显示,MR扩散加权成像对肝纤维化诊断的敏感性和特异性均高于CT灌注成像,分别为78.9%,82.6%和66.67%,73.91。
结论:
1.进食后肝血流灌注增加,可引起肝ADC值的改变,以b值200s/mm~2时为著;右前叶受血流灌注影响大于右后叶,因此右后叶是ADC测量时最为可靠的ROI放置位置。
2.MR扩散加权成像ADC值肝纤维化程度的加重逐渐降低,并可通过ADC值对肝纤维化进行分级,因此,ADC值对肝纤维化的早期诊断及分级有重要价值。
3.CT灌注成像各参数中HAF可将纤维化程度较重组(S3,S4)与对照组相区分,对肝纤维化的诊断有一定价值。
4.MR扩散加权成像对肝纤维化诊断的敏感性和特异性均高于CT灌注成像,因此本研究认为MR扩散加权成像是目前肝纤维化早期诊断及分级的最佳检查手段。
Objective: according to the change of ADC value in right anterior lobe and right posterior lobe after food in-take, to evaluate the effect of hemodynamic change caused by food in-take and different ROI on hepatic DWI; To observe the changes of the ADC value of patients in different grade of fibrosis, and analyze it's correlation with pathologic result, and then to evaluate the value of DWI in staging of liver fibrosis; To observe the changes of the CTP parameters of patient in different grade of fibrosis, and analyze it's correlation with pathologic result, then compare them with the results of DWI research, to evaluate the diagnostic value of DWI and CTP in staging of liver fibrosis.
Materials and methods: 23 healthy volunteers (male 18, female 5,averaged age 36.3) underwent DWI examination fasting for 8 hours and 1 hour after taking standard meal, the b values for DWI were 200 s/mm2, 500 s/mm2and 700 s/mm2. The ADC values of right anterior lobe and right posterior lobe under different b value were measured respectively. Paired t test was used to compare the ADC value of fasting and postprandial, and also was used to compare the ADC value of right anterior lobe and right posterior lobe. 57 patients with hepatic fibrosis (male 18,female 5,averaged age 38.6, S1～S4 is 21,16,17,3 respectively ) and 23 control group (male 18, female 5,averaged age 36.3) underwent DWI (b=500 s/mm~2) . The ADC value of different fibrosis stage and different inflammatory stage, the ROI were placed in right posterior lobe, about 1 cm. analysis of variance was used to compare the difference among all the groups. 36 patients with liver fibrosis(male 25,female 11,averaged age 41.5 ) and 23 control group (male 18, female 5,averaged age 36.3) underwent dynamic spiral CTP. CTP parameters including hepatic blood flow(BF), blood volume(BV), hepatic arterial fraction(HAF), mean transit time(MTT), permeability surface(PS) were obtained through liver perfusion analysis software. analysis of variance was used to compare the difference among all the groups, ROC curve was used to analyze the sensitivity and specificity of DWI and CTP.
Result: when b value was 200 s/mm2, the postprandial ADC value of right anterior lobe and right posterior lobe both increased obviously (P =0.000, 0.001) ; when b was 500 s/mm~2 and 700 s/mm~2, the postprandial ADC value of right anterior lobe increased obviously (P=0.001, 0.003) , but that of right posterior lobe did not change (P =0.110, 0.076) . When fasting, the difference of ADC value between right anterior lobe and right posterior lobe were not significant (P=0.324, 0.163, 0.854) , but it was significant after food in-take(P=0.030, 0.036, 0.033). The difference of ADC value between control group and S1 group was not significant, that between control group and S2,S3,S4 group was significant (Pe =0.000,0.000,0.000) , that between S2 group and S3 group , S3 group and S4 group , S3 group and S4 group was significant (P =0.006,0.000,0.003) . The difference of ADC value between G0 group and G2,G3,G4 group were significant (P =0.001,0.002,0.008) ,that between G1 group and G2,G3,G4 group were significant (P =0.013,0.010,0.027) ;HAF between control group and S3-4 group were different (P =0.004) , the sensitivity and specificity of DWI and CTP was 78.9%, 82 .6% and 66.67%, 73.91% respectively.
Conclusion: The ADC value of right posterior lobe is more precise than right anterior lobe, which is the best location for the measure of ADC value. 500 s/mm~2 is the best b value for the measurement of ADC value in hepatic DWI examination. DWI can reflect the change of liver fibrosis earlier than traditional imaging, S2,S3,S4 group can be distinguished according to the change of ADC value, and ADC value can reflect the degree of inflammation roughly. ADC value can be used as an important index for the early diagnosis of liver fibrosis. HAF can distinguish control group and S3-4 group. DWI is the best examination for the diagnosis and stage of fibrosis.
研究方法:23例受试者(男性18例,女性5例,平均年龄为36.3岁)于禁食8小时及标准餐后1小时分别行DWI检查,b值选择为200 s/mm~2,500 s/mm~2及700 s/mm~2。分别测量餐前餐后各b值条件下右前叶及右后叶ADC值。对两叶进食前后ADC值进行配对t检验,观察进食对两叶ADC值的影响;对进食前后两叶ADC值进行配对t检验,比较不同饮食状态下两叶ADC值有无差别。对57例肝纤维化病人(其中男性43例,女性14例,平均年龄为38.6岁,肝纤维化S1-S4分别为21例,16例,17例,3例)及23例对照组(男性18例,女性5例,平均年龄为36.3岁)进行DWI(b值为500 s/mm~2)检查,ADC值测量过程中,圆形兴趣区放置于右后叶,直径约为1cm。将测得的不同纤维化分级及炎症分级的ADC值进行单因素方差分析,方差齐且组间差别有统计学意义者,采用SNK-q检验进行方差分析及两两比较;方差不齐且组间差别有统计学意义者,采用Dunnett-t3检验进行方差分析及两两比较。对36例肝纤维化病人(其中男性25例,女性11例,平均年龄为41.5岁)及23例对照组(男性18例,女性5例,平均年龄为36.3岁)进行CT灌注检查,用肝灌注分析软件取得不同肝纤维化分级病人肝实质的灌注参数,包括BF,BV,MTT,HAF,PS。将测得的参数进行单因素方差分析,方差齐且组间差别有统计学意义者,采用SNK-q检验进行方差分析及两两比较;方差不齐且组间差别有统计学意义者,采用Dunnett-t3检验进行方差分析及两两比较。对57例肝纤维化病人的MR扩散加权成像研究结果和36例肝纤维化病人的CT灌注成像研究结果进行比较,通过Medcalc统计软件绘制ROC曲线比较两者对肝纤维化诊断的敏感性和特异性。
结果:b值为200 s/mm~2时右前叶及右后叶餐后ADC值均明显增加,差别有统计学意义(P值分别为0.000,0.001);b值为500 s/mm~2及700 s/mm~2时,右前叶餐后ADC值明显增加,差别有统计学意义(P值分别为0.001,0.003),右后叶餐后ADC值的改变无统计学意义(P值分别为0.110,0.076)。餐前各b值条件下右前叶与右后叶ADC值差别无统计学意义(P值分别为0.324,0.163,0.854);餐后各b值条件下右前叶及右后叶ADC值差别均有统计学意义(P值分别为0.030,0.036,0.033)。
正常对照组与肝纤维化S1组间ADC值差别无统计学意义,与肝纤维化S2,S3,S4组间差别均有统计学意义(P值均为0.000);肝纤维化S1组与S2,S3,S4组间差别均有统计学意义(P值均为0.000);肝纤维化S2与S3,S4组间差别有统计学意义(P值分别为0.006,0.000);肝纤维化S3与S4组间差别有统计学意义(P值为0.003)。G0组与G2,G3,G4各组间ADC值差别有统计学意义(P值分别为0.001,0.002,0.008),G1组与G2,G3,G4组间ADC值差别有统计学意义(P值分别为0.013,0.010,0.027)。
BV、BF、MTT、PS在各组间差别无统计学意义。HAF在正常对照组与纤维化较重组(S3-4组)间差别有统计学意义(P值均为0.004)。两种成像方法的比较研究结果显示,MR扩散加权成像对肝纤维化诊断的敏感性和特异性均高于CT灌注成像,分别为78.9%,82.6%和66.67%,73.91。
结论:
1.进食后肝血流灌注增加,可引起肝ADC值的改变,以b值200s/mm~2时为著;右前叶受血流灌注影响大于右后叶,因此右后叶是ADC测量时最为可靠的ROI放置位置。
2.MR扩散加权成像ADC值肝纤维化程度的加重逐渐降低,并可通过ADC值对肝纤维化进行分级,因此,ADC值对肝纤维化的早期诊断及分级有重要价值。
3.CT灌注成像各参数中HAF可将纤维化程度较重组(S3,S4)与对照组相区分,对肝纤维化的诊断有一定价值。
4.MR扩散加权成像对肝纤维化诊断的敏感性和特异性均高于CT灌注成像,因此本研究认为MR扩散加权成像是目前肝纤维化早期诊断及分级的最佳检查手段。
Objective: according to the change of ADC value in right anterior lobe and right posterior lobe after food in-take, to evaluate the effect of hemodynamic change caused by food in-take and different ROI on hepatic DWI; To observe the changes of the ADC value of patients in different grade of fibrosis, and analyze it's correlation with pathologic result, and then to evaluate the value of DWI in staging of liver fibrosis; To observe the changes of the CTP parameters of patient in different grade of fibrosis, and analyze it's correlation with pathologic result, then compare them with the results of DWI research, to evaluate the diagnostic value of DWI and CTP in staging of liver fibrosis.
Materials and methods: 23 healthy volunteers (male 18, female 5,averaged age 36.3) underwent DWI examination fasting for 8 hours and 1 hour after taking standard meal, the b values for DWI were 200 s/mm2, 500 s/mm2and 700 s/mm2. The ADC values of right anterior lobe and right posterior lobe under different b value were measured respectively. Paired t test was used to compare the ADC value of fasting and postprandial, and also was used to compare the ADC value of right anterior lobe and right posterior lobe. 57 patients with hepatic fibrosis (male 18,female 5,averaged age 38.6, S1～S4 is 21,16,17,3 respectively ) and 23 control group (male 18, female 5,averaged age 36.3) underwent DWI (b=500 s/mm~2) . The ADC value of different fibrosis stage and different inflammatory stage, the ROI were placed in right posterior lobe, about 1 cm. analysis of variance was used to compare the difference among all the groups. 36 patients with liver fibrosis(male 25,female 11,averaged age 41.5 ) and 23 control group (male 18, female 5,averaged age 36.3) underwent dynamic spiral CTP. CTP parameters including hepatic blood flow(BF), blood volume(BV), hepatic arterial fraction(HAF), mean transit time(MTT), permeability surface(PS) were obtained through liver perfusion analysis software. analysis of variance was used to compare the difference among all the groups, ROC curve was used to analyze the sensitivity and specificity of DWI and CTP.
Result: when b value was 200 s/mm2, the postprandial ADC value of right anterior lobe and right posterior lobe both increased obviously (P =0.000, 0.001) ; when b was 500 s/mm~2 and 700 s/mm~2, the postprandial ADC value of right anterior lobe increased obviously (P=0.001, 0.003) , but that of right posterior lobe did not change (P =0.110, 0.076) . When fasting, the difference of ADC value between right anterior lobe and right posterior lobe were not significant (P=0.324, 0.163, 0.854) , but it was significant after food in-take(P=0.030, 0.036, 0.033). The difference of ADC value between control group and S1 group was not significant, that between control group and S2,S3,S4 group was significant (Pe =0.000,0.000,0.000) , that between S2 group and S3 group , S3 group and S4 group , S3 group and S4 group was significant (P =0.006,0.000,0.003) . The difference of ADC value between G0 group and G2,G3,G4 group were significant (P =0.001,0.002,0.008) ,that between G1 group and G2,G3,G4 group were significant (P =0.013,0.010,0.027) ;HAF between control group and S3-4 group were different (P =0.004) , the sensitivity and specificity of DWI and CTP was 78.9%, 82 .6% and 66.67%, 73.91% respectively.
Conclusion: The ADC value of right posterior lobe is more precise than right anterior lobe, which is the best location for the measure of ADC value. 500 s/mm~2 is the best b value for the measurement of ADC value in hepatic DWI examination. DWI can reflect the change of liver fibrosis earlier than traditional imaging, S2,S3,S4 group can be distinguished according to the change of ADC value, and ADC value can reflect the degree of inflammation roughly. ADC value can be used as an important index for the early diagnosis of liver fibrosis. HAF can distinguish control group and S3-4 group. DWI is the best examination for the diagnosis and stage of fibrosis.
引文
1.Bonis PA,Friedman SL,Kaplan MM.Is liver fibrosis reversible? N Engl J Med,2001,344(6):452-454
2.李东,李兵顺.肝纤维化逆转研究近况.实用肝脏病杂志,2003,6(1):53-55
3.Malekzadeh R,Mohamadnejad M,Rakhshani N,et al.Reversibility of cirrhosis in chronic hepatitis B.Clin Gastroenterol Hepatol,2004,2:344-347.
4.Poynard T,McHutchison J,Davis GL,et al.Impact of interferon alpha-2b and ribavirin on progression of liver fibrosis in patients with chronic hepatitis C.Hepatology,2000,32:1131-1137.
5.Wanless IR,Nakashima E,Sherman M.Regression of human cirrhosis.Morphologic features and the genesis of incomplete septal cirrhosis.Arch Pathol Lab Med,2000,124:1599-1607.
6.王虹,姚光弼.肝纤维化和肝硬化的非侵入性诊断方法.胃肠病学和肝病学杂志,2007,16(1):100-105
7.王霞.肝纤维化相关血清标志物的联合检测与临床应用研究.中国实验诊断学,2006,10(11):1339-1341
8.陆玮,陆思源.肝纤维化诊断和治疗进展.国际消化病杂志,2006,26(1):2-4
9.陈杰,陈新月.肝纤维化诊断研究进展.国际流行病学传染病学杂志,2006,33(6):413-415
10.Wong JB,Bennett WG,Koff RS,et al.Pauker SG.Pretreatment evaluation of chronic hepatitis C:risks,benefits,and costs.JAMA,1998;280:2088-2093.
11.Non-invasive evaluation of hepatic fibrosis:don't count your chickens before they're hatched.Gut,2006,55:310-312
12.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes in liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br.J.Clin.Pharmacol.,1996;42:499-502
13.Katsuhiro N,~oshifumi K,Ryuzo S,et al.Measurement of the apparent diffusion coefficient in the liver:is it a reliable index for hepatic disease diagnosis?Radiat Med,2006,24:438-444
14.Namimoto T,Yamashita Y,Sumi S,et al.Focal liver masses:characterization with diffusion-weighted echo-planar MR imaging.Radiology,1997,204:739-744.
15.Ichikama T,Haradome H,Hachiya J,et al.Diffusion-weighted MR imaging with a single-shot echoplanar sequences:detection and characterization of focal hepatic lesions.AJR,1998,170:397-402.
16.Yamashita Y,Tang Y,Takahashi M,et al.Ultrafast MR imaging of the abdomen:echo planar imaging and diffusion-weighted imaging.J Magn Reson Imaging,1998,8:367-374.
17.Kim T,Murakami T,Takahashi S,et al.Diffusion-weighted single-shot echoplanar MR imaging for liver disease.AJR,1999,173:393-398.
18.Stejskal ED,Tanner JE.Spin diffusion measurements:spin echoes in the presence of time dependent field gradient.J Chem Phys,1965,42(1):288-292
19.Manfield P.Multi—plannar im age formation using NMR spin echoes.J Phys,1977,10(1):55-58.
20.Ichikawa T,Araki T.Fast Magnetic Resonance Imaging of liver.Eur J Radioi,1999,29(3):186-210
21.张安君,詹松华,徐技峰,等.背景抑制磁共振弥散成像(DWIBS)技术在肝脏局灶性占位性病变中的初步应用.中国中西医结合影像学杂志,2006,4(4):241-243
22.Murtz P,Flacke S,Traber F,et al.Abdomen:Diffusion—Weighted MR Imaging with Pulse Triggered Single-shot sequences.Radiology,2002,224(1):258-264
23.Nasu K,Kuroki Y,Sekiguchi R,et al.The effect of simultaneous use of respiratory triggering in diffusion-weighted imaging of the liver.Magn Reson Med Sci,2006,5(3):129-36
24.Taouli B,Valerie V,Erik D,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single shot echo-planar MR imaging sequences:prospective study in66patients.Radiology,2003,226:71-78.
25.Boulanger Y,Amara M,Lepanto L,etal.Diffusion-weighted MR imaging of the liver of hepatitis C patients.NMR Biomed,2003,16:132-136
26.刘玉品,杨小庆.肝占位病变扩散加权成像的影像质量评价.实用放射学杂志,2006,22(8),962-966
27.Le BD,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology,1988,168:497-505.
28.Thomsen C,Stahlberg F,Henriksen O.Effect of food intake on portal vein volume flow.Proc.SMRM,1991,10:809
29.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes In liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br J Clin Pharmacol,1996,42(4):499-502.
30.Ichikawa T,Haradome H,Hachiya J,et al.Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen:preliminary clinical experience in 61 patients.Abdom Imaging,1999,24(5):456-461
31.张冰,朱斌,祝新.DWI及ADC值在肝脏弥漫性疾病诊断中的应用价值.医学影像学杂志,2007,17(1):42-45
32.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion-weighted imaging in the diagnosis of diffuse liver diseases in rats.Chinese Medical Journal,2005,118(8),639-644
33.陈达信,金惠铭.正常及病理情况下的肝脏微循环.中华医学杂志,1985,65(2):119-122
34.Shiratori Y,Tananka M,Kawase T,et al.Quantification of sinusoidal cell function in vivo.Sem in Liver Dis,1993,13(1):39-49
35.黄晓强,黄志强,杨可祯.肝脏微循环在肝硬化及胆管阻塞时的改变.国外医学外科学分册,1986,13(6):321-324
36.贾一韬,曾民德.肝窦毛细血管化的研究进展.国外医学消化系疾病分册,2000,20(2):86-90
37.孔宪涛,高锋.肝纤维化的实验与临床研究.第二军医大学学报,1996,17(1):1}-5
38.徐钧,杨镇.肝星状细胞对肝脏微循环调节机制的研究进展.中华实验外科杂志,2003,20(2):189-190
39.Bedossa P,Dargere D,Paradis V1 Sampling variability of liver fibrosis in chronic hepatitis C.Hepatology,2003,38:1449-1457
40.Muller M F,Prasad P,Siewer tB,etal.Abdominal diffusion mapping with use of a whole body echo planar system.Radiology,1994,190(2):475-478
41.Amano Y,Kumazaki T,Ishihara M.Single-shot diffusion-weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil.Acta Radiol,1998,39:440-442.
42.Aube C,Racineux PX,Lebigot J,et al.Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging:preliminary results.Radiol,2004,85:301-306.
43.Taouli B,Vilgrain V,Dumont E,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences:prospective study in 66 patients.Radiology,2003,226:71-78.
44.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion weighted imaging in the diagnosis of diffuse liver disease in rats.Chin Med J,2005,118(8):639-644
45.胡晓峰,刘斌 家兔肝纤维化模型的建立及影像学初步研究
46.王秋实,郭启勇,梁长虹等.MR弥散加权成像评价肝纤维化的初步试验研究.解剖学研究,2007,129(3),212-216
47.Koinuma M,Ohashi l,Hanafusa K,etal.Apparent diffusion coefficient measurement with diffusion weighted magnetic Resonance imaging for evaluation of hepatic fibrosis.J Magn Reson Imaging,2005,22(1):80-85
48.昊芯,宋彬.影像学新技术在消化系统的临床应用.中国普外基础与临床杂志,2007,14(2),22
49.杨洋,宋彬,吴芯慢性病毒性肝炎组织病理学分级和磁共振弥散成像的对照研究.中国普外基础与临床杂志,2006,13(4):469
50.Annet L,Peeters F,Abarca Q,et al.Assessmentof diffusion weighted MR imaging in liver fibrosis.J Magn Reson Imaging,2007,25(1):122
51.Laurence A,Frank P,Jorge AQ,et al.Assessment of Diffusion-Weighted MR Imaging in Liver Fibrosis.JOURNAL OF MAGNETIC RESONANCE IMAGING,2007,25:122 - 128
52.Miles KA.Hayball M,Dixon AK.Colour perfusion imaging:a new application of computed tomography.Lancet,1991,337(3):643-645
53.范光明,郭启勇.肝脏CT灌注成像的研究进展.中国医学影像技术,2004,20(2):298-301
54.Tsushima Y,Bloomley M J,Kusano S,et al.The portal component of hepatic perfusion measured by dynamic CT:an indicator of hepatic parenchyma.Dig Dis Sci,1999,44(8):1632-8
55.Lee SJ,Lee KH,Na DG,et al.Multiphasic helical computed tomography predicts subsequent development of severe brain edema in acute ischemic stroke.Arch Neurol,2004,61:505-509
56.Tsushima Y,Unno Y,Koizumi J,et al.Hepatic perfusion changes after transcatheter arterial embolization(TAE)of hepatocellular carcinoma:measurementby dynamic computed tomography(CT).Dig Dis Sci,1998,43:317-322
57.Eastwood JD,Lev MH,Azhari T,et al.CT perfusion scanning with deconvolution analysis:pilot study in patients with acute middle cerebral artery stroke.Radiology,2002,222:227-236
58.Na DG,Ryoo JW,Lee KH,et al.Multiphasic perfusion computed tomography in hyperacute ischemic stroke:comparison with diffusion and perfusion magnetic resonance imaging.J Comput Assist Tomogr,2003,27:194-206
59.Furukawa M,Kashiwagi S,Matsunaga N,et al.Evaluation of cerebral perfusion parameters measured by perfusion CT in chronic cerebral ischemia:comparison with xenon CT.J Comput Assist Tomogr,2002,26:272-278
60.Gandhi D,Hoeffner EG,Carlos RC,et al.Computed tomography perfusion of squamous cell carcinoma of the upper aerodigestive tract.Initial results.J Comput Assist Tomogr,2003,27:687-693
61.Hashimoto K,Murakami T,Dono K,et al.Quantitative tissue blood flow measurement of the liver parenchyma:comparison between xenon CT and perfusion CT.Dig Dis Sci,2007,52:943-949.
62.梁扩寰,李绍白主编.肝脏病学(第二版).北京:人民卫生出版社.2002:6-16
63.Kopka L,Rogalla P,Hamm B.Multislice CT of the abdomen-current indications and future trends.Rofo,2002,174:273-282
64.Eastwood JD,Lev MH,Wintermark M,et al.Correlation of early dynamic CT perfusion imaging with wholebrain MR diffusion and perfusion imaging in acute hemispheric stroke.Am J Neuroradiol.2003,24:1869-1875
65.Pandharipande PV,Krinsky GA,Rusinek H,et al.Perfusion imaging of the liver:current challenges and future goals.Radiology,2005,234:661-673
66.Hashimoto K,Murakami T,Dono K,et al.Assessment of the severity of liver disease and fibrotic change:the usefulness of hepatic CT perfusion imaging.Oncol Rep,2006,16:667-683.
67.江利,杨建勇,谢洪波,等.CT灌注成像对肝硬化血流动力学的临床研究.中华放射学杂志,2004,38:1081-1086
68.Nakashige A,Horiguchi J,Tamura A,et al.Quantitative measurement of hepatic portal perfusion by multidetector row CT with compensation for respiratory misregistration.Br J Radiol,2004,77:728-73
69.Guan S,Zhao WD,Zhou KR,et al.Experimental study of CT perfusion in hepatitis,hepatic fibrosis and early stage of cirrhosis.Chin J Radiol,2005,39(8),877-881
70.Shi LJ,Li SP,Tian JM,et al.Comparison of the differential diagnostic value of CT perfusion,MR perfusion and DWI in liver diseases.Chin J Radiol,2007
71.姜慧杰,张在人.CT灌注成像的原理和在肝脏肿瘤诊断中的应用.临床放射学杂志,2007,26(10):1046-1049
72.李艳英,刘悦,张在人.多层螺旋CT灌注成像对肝转移瘤的诊断价值.世界华人消化杂志,2006,14(15):1498-1501
73.卞读军,胡冬煦,肖恩华,等.磁共振扩散加权成像对肝脏局灶病变的价值.世界华人消化杂志 2007,15(22):2418-2423
74.王康,王培军,赵泽华,等.功能磁共振成像在乙型肝炎相关慢性肝病检测中的应用.中华肝脏病杂志 2006,14(8):590-596
1.Stejskal ED,Tanner JE.Spin diffusion measurements:spin echoes in the presence of time dependent field gradient.J Chem Phys,1965,42(1):288-292
2.Manfield P.Multi-plannar image formation using NMR spin echoes.J Phys,1977,10(1):55-58
3.Murtz P,Flacke S,Traber F,et al.Abdomen:Diffusion—Weighted MR Imaging with Pulse Triggered Single-shot sequences.Radiology,2002,224(1):258-264.
4.Muller MF,Prasad P,Siewert B,et al.Abdominal diffusion mapping with use of a whole body echo planar system.Radiology,199,4,190(2):475-478
5.Amano Y,Kumazaki T,Ishihara M.Single-shot diffusion-weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil.Acta Radiol,1998,39:440-442.
6.Aube C,Racineux PX,Lebigot J,et al.Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging:preliminary results.Radiol,2004,85:301-306.
7.Ta uli B,Vilgrain V,Dumont E,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences:prospective study in 66 patients.Radiology,2003,226:71-78.
8.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion weighted imaging in the diagnosis of diffuse liver disease in rats.Chin Med J,2005,118(8):639-644
9.胡晓峰,刘斌 家兔肝纤维化模型的建立及影像学初步研究
10 王秋实,郭启勇,梁长虹等.MR弥散加权成像评价肝纤维化的初步试验研究.解剖学研究,2007,129(3),212-216
11.Koinuma M,Ohashi l,Hanafusa K,et al.Apparent diffusion coefficient measurement with diffusion weighted magnetic Resonance imaging for evaluation of hepatic fibrosis.J Magn Reson Imaging,2005,22(1):80-85
13 Kim T,Murakami T,Takahashi S,et al.Diffusion-weighted single-shot echo planar MR imaging for liver disease.AJR Am J Roentgenol,1999,173:393-398.
14.Laurence A,Frank P,Jorge A Q,et al.Assessment of Diffusion-Weighted MR Imaging in Liver Fibrosis.J Magn Reson lmaging,2007,25(1):122-128
15.Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology,1988,168:497-505.
16.Boulanger Y,Amara M,Lepanto L,et al.Diffusion-weighted MR imaging of the liver of hepatitis C patients.NMR Biomed,2003,16:132-136
17.Ichikawa T,Haradome H,Hachiya J,etal.Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen:preliminary clinical experience in 61 patients.Abdom Imaging,1999,24(5):456-461
18.刘玉品,杨小庆.肝占位病变扩散加权成像的图像质量评价.实用放射学杂志,2006,22(8),962-966
19.孙希杰,金显跃,梁文,等.肝脏病变的磁共振弥散成像的量化研究初探.实用放射学杂志,2003,19(7):596-599.
20.Dietrich O,Heiland S,Benner T,et al.Reducing motion artefacts in diffusion-weighted MRI of the brain:efficacy of navigator echo correction and pulse triggering.Neuroradiology.2000,42(2):85-91.
21.Kennedy SD,Zhong J.Diffusion measurements free of motion artifacts using intermolecular dipole-dipole interactions.Magn Reson Med,2004,52(1):1-6.
22.Takahara T,Imai Y,Yamashita T,et al.Diffusion weighted whole body imaging with background body signal suppression(DWIBS):technical improvement using free breathing,STIR and high resolution 3D display.Radiat Med,2004,22:275-282.
23.Lycklama GJ,Burggraaf K,Wasser MNJM,et al.Variability of splanchnic blood flow measurements using MR velocity mapping under fasting and post-prandial conditions-comparison with echo-Doppler.J.Hepatol,1997,26:298-304.
24.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes In liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br J Clin Pharmacol,1996,42(4):499-502.
25.Hollingsworth KG,Lomas DJ.Influence of perfusion on hepatic MR diffusion measurement.NMR Biomed,2006,19(2):231-235
26.Nasu K,Kuroki Y,Sekiquchi R,etal.Measurement of the apparent diffusion coefficient in the liver:is it a reliable index for hepatic disease diagnosis? Radiat Meal,2006,24(6):438-44.
2.李东,李兵顺.肝纤维化逆转研究近况.实用肝脏病杂志,2003,6(1):53-55
3.Malekzadeh R,Mohamadnejad M,Rakhshani N,et al.Reversibility of cirrhosis in chronic hepatitis B.Clin Gastroenterol Hepatol,2004,2:344-347.
4.Poynard T,McHutchison J,Davis GL,et al.Impact of interferon alpha-2b and ribavirin on progression of liver fibrosis in patients with chronic hepatitis C.Hepatology,2000,32:1131-1137.
5.Wanless IR,Nakashima E,Sherman M.Regression of human cirrhosis.Morphologic features and the genesis of incomplete septal cirrhosis.Arch Pathol Lab Med,2000,124:1599-1607.
6.王虹,姚光弼.肝纤维化和肝硬化的非侵入性诊断方法.胃肠病学和肝病学杂志,2007,16(1):100-105
7.王霞.肝纤维化相关血清标志物的联合检测与临床应用研究.中国实验诊断学,2006,10(11):1339-1341
8.陆玮,陆思源.肝纤维化诊断和治疗进展.国际消化病杂志,2006,26(1):2-4
9.陈杰,陈新月.肝纤维化诊断研究进展.国际流行病学传染病学杂志,2006,33(6):413-415
10.Wong JB,Bennett WG,Koff RS,et al.Pauker SG.Pretreatment evaluation of chronic hepatitis C:risks,benefits,and costs.JAMA,1998;280:2088-2093.
11.Non-invasive evaluation of hepatic fibrosis:don't count your chickens before they're hatched.Gut,2006,55:310-312
12.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes in liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br.J.Clin.Pharmacol.,1996;42:499-502
13.Katsuhiro N,~oshifumi K,Ryuzo S,et al.Measurement of the apparent diffusion coefficient in the liver:is it a reliable index for hepatic disease diagnosis?Radiat Med,2006,24:438-444
14.Namimoto T,Yamashita Y,Sumi S,et al.Focal liver masses:characterization with diffusion-weighted echo-planar MR imaging.Radiology,1997,204:739-744.
15.Ichikama T,Haradome H,Hachiya J,et al.Diffusion-weighted MR imaging with a single-shot echoplanar sequences:detection and characterization of focal hepatic lesions.AJR,1998,170:397-402.
16.Yamashita Y,Tang Y,Takahashi M,et al.Ultrafast MR imaging of the abdomen:echo planar imaging and diffusion-weighted imaging.J Magn Reson Imaging,1998,8:367-374.
17.Kim T,Murakami T,Takahashi S,et al.Diffusion-weighted single-shot echoplanar MR imaging for liver disease.AJR,1999,173:393-398.
18.Stejskal ED,Tanner JE.Spin diffusion measurements:spin echoes in the presence of time dependent field gradient.J Chem Phys,1965,42(1):288-292
19.Manfield P.Multi—plannar im age formation using NMR spin echoes.J Phys,1977,10(1):55-58.
20.Ichikawa T,Araki T.Fast Magnetic Resonance Imaging of liver.Eur J Radioi,1999,29(3):186-210
21.张安君,詹松华,徐技峰,等.背景抑制磁共振弥散成像(DWIBS)技术在肝脏局灶性占位性病变中的初步应用.中国中西医结合影像学杂志,2006,4(4):241-243
22.Murtz P,Flacke S,Traber F,et al.Abdomen:Diffusion—Weighted MR Imaging with Pulse Triggered Single-shot sequences.Radiology,2002,224(1):258-264
23.Nasu K,Kuroki Y,Sekiguchi R,et al.The effect of simultaneous use of respiratory triggering in diffusion-weighted imaging of the liver.Magn Reson Med Sci,2006,5(3):129-36
24.Taouli B,Valerie V,Erik D,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single shot echo-planar MR imaging sequences:prospective study in66patients.Radiology,2003,226:71-78.
25.Boulanger Y,Amara M,Lepanto L,etal.Diffusion-weighted MR imaging of the liver of hepatitis C patients.NMR Biomed,2003,16:132-136
26.刘玉品,杨小庆.肝占位病变扩散加权成像的影像质量评价.实用放射学杂志,2006,22(8),962-966
27.Le BD,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology,1988,168:497-505.
28.Thomsen C,Stahlberg F,Henriksen O.Effect of food intake on portal vein volume flow.Proc.SMRM,1991,10:809
29.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes In liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br J Clin Pharmacol,1996,42(4):499-502.
30.Ichikawa T,Haradome H,Hachiya J,et al.Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen:preliminary clinical experience in 61 patients.Abdom Imaging,1999,24(5):456-461
31.张冰,朱斌,祝新.DWI及ADC值在肝脏弥漫性疾病诊断中的应用价值.医学影像学杂志,2007,17(1):42-45
32.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion-weighted imaging in the diagnosis of diffuse liver diseases in rats.Chinese Medical Journal,2005,118(8),639-644
33.陈达信,金惠铭.正常及病理情况下的肝脏微循环.中华医学杂志,1985,65(2):119-122
34.Shiratori Y,Tananka M,Kawase T,et al.Quantification of sinusoidal cell function in vivo.Sem in Liver Dis,1993,13(1):39-49
35.黄晓强,黄志强,杨可祯.肝脏微循环在肝硬化及胆管阻塞时的改变.国外医学外科学分册,1986,13(6):321-324
36.贾一韬,曾民德.肝窦毛细血管化的研究进展.国外医学消化系疾病分册,2000,20(2):86-90
37.孔宪涛,高锋.肝纤维化的实验与临床研究.第二军医大学学报,1996,17(1):1}-5
38.徐钧,杨镇.肝星状细胞对肝脏微循环调节机制的研究进展.中华实验外科杂志,2003,20(2):189-190
39.Bedossa P,Dargere D,Paradis V1 Sampling variability of liver fibrosis in chronic hepatitis C.Hepatology,2003,38:1449-1457
40.Muller M F,Prasad P,Siewer tB,etal.Abdominal diffusion mapping with use of a whole body echo planar system.Radiology,1994,190(2):475-478
41.Amano Y,Kumazaki T,Ishihara M.Single-shot diffusion-weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil.Acta Radiol,1998,39:440-442.
42.Aube C,Racineux PX,Lebigot J,et al.Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging:preliminary results.Radiol,2004,85:301-306.
43.Taouli B,Vilgrain V,Dumont E,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences:prospective study in 66 patients.Radiology,2003,226:71-78.
44.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion weighted imaging in the diagnosis of diffuse liver disease in rats.Chin Med J,2005,118(8):639-644
45.胡晓峰,刘斌 家兔肝纤维化模型的建立及影像学初步研究
46.王秋实,郭启勇,梁长虹等.MR弥散加权成像评价肝纤维化的初步试验研究.解剖学研究,2007,129(3),212-216
47.Koinuma M,Ohashi l,Hanafusa K,etal.Apparent diffusion coefficient measurement with diffusion weighted magnetic Resonance imaging for evaluation of hepatic fibrosis.J Magn Reson Imaging,2005,22(1):80-85
48.昊芯,宋彬.影像学新技术在消化系统的临床应用.中国普外基础与临床杂志,2007,14(2),22
49.杨洋,宋彬,吴芯慢性病毒性肝炎组织病理学分级和磁共振弥散成像的对照研究.中国普外基础与临床杂志,2006,13(4):469
50.Annet L,Peeters F,Abarca Q,et al.Assessmentof diffusion weighted MR imaging in liver fibrosis.J Magn Reson Imaging,2007,25(1):122
51.Laurence A,Frank P,Jorge AQ,et al.Assessment of Diffusion-Weighted MR Imaging in Liver Fibrosis.JOURNAL OF MAGNETIC RESONANCE IMAGING,2007,25:122 - 128
52.Miles KA.Hayball M,Dixon AK.Colour perfusion imaging:a new application of computed tomography.Lancet,1991,337(3):643-645
53.范光明,郭启勇.肝脏CT灌注成像的研究进展.中国医学影像技术,2004,20(2):298-301
54.Tsushima Y,Bloomley M J,Kusano S,et al.The portal component of hepatic perfusion measured by dynamic CT:an indicator of hepatic parenchyma.Dig Dis Sci,1999,44(8):1632-8
55.Lee SJ,Lee KH,Na DG,et al.Multiphasic helical computed tomography predicts subsequent development of severe brain edema in acute ischemic stroke.Arch Neurol,2004,61:505-509
56.Tsushima Y,Unno Y,Koizumi J,et al.Hepatic perfusion changes after transcatheter arterial embolization(TAE)of hepatocellular carcinoma:measurementby dynamic computed tomography(CT).Dig Dis Sci,1998,43:317-322
57.Eastwood JD,Lev MH,Azhari T,et al.CT perfusion scanning with deconvolution analysis:pilot study in patients with acute middle cerebral artery stroke.Radiology,2002,222:227-236
58.Na DG,Ryoo JW,Lee KH,et al.Multiphasic perfusion computed tomography in hyperacute ischemic stroke:comparison with diffusion and perfusion magnetic resonance imaging.J Comput Assist Tomogr,2003,27:194-206
59.Furukawa M,Kashiwagi S,Matsunaga N,et al.Evaluation of cerebral perfusion parameters measured by perfusion CT in chronic cerebral ischemia:comparison with xenon CT.J Comput Assist Tomogr,2002,26:272-278
60.Gandhi D,Hoeffner EG,Carlos RC,et al.Computed tomography perfusion of squamous cell carcinoma of the upper aerodigestive tract.Initial results.J Comput Assist Tomogr,2003,27:687-693
61.Hashimoto K,Murakami T,Dono K,et al.Quantitative tissue blood flow measurement of the liver parenchyma:comparison between xenon CT and perfusion CT.Dig Dis Sci,2007,52:943-949.
62.梁扩寰,李绍白主编.肝脏病学(第二版).北京:人民卫生出版社.2002:6-16
63.Kopka L,Rogalla P,Hamm B.Multislice CT of the abdomen-current indications and future trends.Rofo,2002,174:273-282
64.Eastwood JD,Lev MH,Wintermark M,et al.Correlation of early dynamic CT perfusion imaging with wholebrain MR diffusion and perfusion imaging in acute hemispheric stroke.Am J Neuroradiol.2003,24:1869-1875
65.Pandharipande PV,Krinsky GA,Rusinek H,et al.Perfusion imaging of the liver:current challenges and future goals.Radiology,2005,234:661-673
66.Hashimoto K,Murakami T,Dono K,et al.Assessment of the severity of liver disease and fibrotic change:the usefulness of hepatic CT perfusion imaging.Oncol Rep,2006,16:667-683.
67.江利,杨建勇,谢洪波,等.CT灌注成像对肝硬化血流动力学的临床研究.中华放射学杂志,2004,38:1081-1086
68.Nakashige A,Horiguchi J,Tamura A,et al.Quantitative measurement of hepatic portal perfusion by multidetector row CT with compensation for respiratory misregistration.Br J Radiol,2004,77:728-73
69.Guan S,Zhao WD,Zhou KR,et al.Experimental study of CT perfusion in hepatitis,hepatic fibrosis and early stage of cirrhosis.Chin J Radiol,2005,39(8),877-881
70.Shi LJ,Li SP,Tian JM,et al.Comparison of the differential diagnostic value of CT perfusion,MR perfusion and DWI in liver diseases.Chin J Radiol,2007
71.姜慧杰,张在人.CT灌注成像的原理和在肝脏肿瘤诊断中的应用.临床放射学杂志,2007,26(10):1046-1049
72.李艳英,刘悦,张在人.多层螺旋CT灌注成像对肝转移瘤的诊断价值.世界华人消化杂志,2006,14(15):1498-1501
73.卞读军,胡冬煦,肖恩华,等.磁共振扩散加权成像对肝脏局灶病变的价值.世界华人消化杂志 2007,15(22):2418-2423
74.王康,王培军,赵泽华,等.功能磁共振成像在乙型肝炎相关慢性肝病检测中的应用.中华肝脏病杂志 2006,14(8):590-596
1.Stejskal ED,Tanner JE.Spin diffusion measurements:spin echoes in the presence of time dependent field gradient.J Chem Phys,1965,42(1):288-292
2.Manfield P.Multi-plannar image formation using NMR spin echoes.J Phys,1977,10(1):55-58
3.Murtz P,Flacke S,Traber F,et al.Abdomen:Diffusion—Weighted MR Imaging with Pulse Triggered Single-shot sequences.Radiology,2002,224(1):258-264.
4.Muller MF,Prasad P,Siewert B,et al.Abdominal diffusion mapping with use of a whole body echo planar system.Radiology,199,4,190(2):475-478
5.Amano Y,Kumazaki T,Ishihara M.Single-shot diffusion-weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil.Acta Radiol,1998,39:440-442.
6.Aube C,Racineux PX,Lebigot J,et al.Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging:preliminary results.Radiol,2004,85:301-306.
7.Ta uli B,Vilgrain V,Dumont E,et al.Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences:prospective study in 66 patients.Radiology,2003,226:71-78.
8.Guan S,Zhou KR,Zhao WD,et al.Magnetic resonance diffusion weighted imaging in the diagnosis of diffuse liver disease in rats.Chin Med J,2005,118(8):639-644
9.胡晓峰,刘斌 家兔肝纤维化模型的建立及影像学初步研究
10 王秋实,郭启勇,梁长虹等.MR弥散加权成像评价肝纤维化的初步试验研究.解剖学研究,2007,129(3),212-216
11.Koinuma M,Ohashi l,Hanafusa K,et al.Apparent diffusion coefficient measurement with diffusion weighted magnetic Resonance imaging for evaluation of hepatic fibrosis.J Magn Reson Imaging,2005,22(1):80-85
13 Kim T,Murakami T,Takahashi S,et al.Diffusion-weighted single-shot echo planar MR imaging for liver disease.AJR Am J Roentgenol,1999,173:393-398.
14.Laurence A,Frank P,Jorge A Q,et al.Assessment of Diffusion-Weighted MR Imaging in Liver Fibrosis.J Magn Reson lmaging,2007,25(1):122-128
15.Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology,1988,168:497-505.
16.Boulanger Y,Amara M,Lepanto L,et al.Diffusion-weighted MR imaging of the liver of hepatitis C patients.NMR Biomed,2003,16:132-136
17.Ichikawa T,Haradome H,Hachiya J,etal.Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen:preliminary clinical experience in 61 patients.Abdom Imaging,1999,24(5):456-461
18.刘玉品,杨小庆.肝占位病变扩散加权成像的图像质量评价.实用放射学杂志,2006,22(8),962-966
19.孙希杰,金显跃,梁文,等.肝脏病变的磁共振弥散成像的量化研究初探.实用放射学杂志,2003,19(7):596-599.
20.Dietrich O,Heiland S,Benner T,et al.Reducing motion artefacts in diffusion-weighted MRI of the brain:efficacy of navigator echo correction and pulse triggering.Neuroradiology.2000,42(2):85-91.
21.Kennedy SD,Zhong J.Diffusion measurements free of motion artifacts using intermolecular dipole-dipole interactions.Magn Reson Med,2004,52(1):1-6.
22.Takahara T,Imai Y,Yamashita T,et al.Diffusion weighted whole body imaging with background body signal suppression(DWIBS):technical improvement using free breathing,STIR and high resolution 3D display.Radiat Med,2004,22:275-282.
23.Lycklama GJ,Burggraaf K,Wasser MNJM,et al.Variability of splanchnic blood flow measurements using MR velocity mapping under fasting and post-prandial conditions-comparison with echo-Doppler.J.Hepatol,1997,26:298-304.
24.Burggraaf J,Schoemaker HC,Cohen AF.Assessment of changes In liver blood flow after food intake-comparison of ICG clearance and echo-Doppler.Br J Clin Pharmacol,1996,42(4):499-502.
25.Hollingsworth KG,Lomas DJ.Influence of perfusion on hepatic MR diffusion measurement.NMR Biomed,2006,19(2):231-235
26.Nasu K,Kuroki Y,Sekiquchi R,etal.Measurement of the apparent diffusion coefficient in the liver:is it a reliable index for hepatic disease diagnosis? Radiat Meal,2006,24(6):438-44.