目的探讨磁共振弥散加权成 像(MR-DWI)在评价慢性乙型肝炎患者肝 纤维化程度和炎症活动度方面的应用价 值。方法 对我院收治的102例慢性乙型 肝炎(纤维化组74例，未纤维化组28例) 患者和26例健康志愿者(对照组)行MR平 扫及DWI检查，设置不同的弥散敏感系 数(b)值，测定并比较不同b值时各组表 观弥散系数(ADC)值和不同肝纤维化程 度及不同炎症活动度的ADC值。结果 b 值为100和200s/mm2 时，各组ADC值比较 差异无统计学意义(P＞0.05)；b值为 400、600和800s/mm2 时，肝纤维化组ADC 值显著低于未纤维化组(P＜0.05)；b值 为600和800s/mm2 时，肝纤维化组S3及S4 期ADC值显著低于S0及S1期(P＜0.05)； b值为100、200和400s/mm2 时，不同肝纤 维化程度分期ADC值间差异无统计学意义 (P＞0.05)；b值为800s/mm2 时，肝炎炎 症活动度组G4级ADC值显著低于G1级(P ＜0.01)，不同炎症活动度分级ADC值间 差异无统计学意义(P＞0.05)。结论 MRDWI在评价慢性乙型肝炎患者肝纤维化程 度和炎症活动度方面具有较高的应用价 值，且ADC值与肝纤维化程度和炎症坏死 程度均密切相关，b值为800s/mm2 时效果 最佳。

Objective To investigate the Clinical value of the degree of liver fibrosis and inflammation of hepatitis B by MR-DWI. Methods Admitted to our hospital 102 cases of chronic hepatitis B patients (fibrosis group 74 cases and no fibrosis group 28 cases) and 26 healthy volunteers (control group) underwent MR plain scan and DWI examination,set different b values.Determination of and comparison of different b values each ADC values and different hepatic fibrosis degree and different inflammatory activity of ADC value. Results b values of 100 and 200s/mm2 ,each ADC value difference was not statistically significant (P>0.05);b value of 400,600 and 800s/mm2 ,hepatic fibrosis group,ADC values were significantly lower than those without fibrosis group (P<0.05);b value of 600 and 800s/mm2 ,hepatic fibrosis group S3 and S4 ADC value was significantly lower than that of S0 and S1 (P<0.05);b value is 100,200 and 400s/mm2 ,different liver fibrosis staging ADC values showed no statistical significance (P>0.05);b value of 800s/mm2 ,liver inflammation activity group G4 level ADC value was significantly lower than that of the G1 level (P<0.01),different inflammation activity grade of ADC value differences had no statistical significance (P>0.05). Conclusion DWI in the evaluation of chronic hepatitis B patients with liver fibrosis and inflammation activity degree has a high application value and the ADC values and degrees of hepatic fibrosis and inflammation and necrosis were closely related,the effect is best of b value of 800s/mm2.