目的 比较实时超声弹性成像 (RTE)与磁共振扩散加权成像(DWI)对慢 性乙型病毒性肝炎(CHB)肝纤维化分级的 临床价值差异。方法 选取88例CHB患者 为受试对象,均予以RTE和DWI检查。以肝 活检病理学检查结果为依据，将88例患 者分为S0组、S1～S2级组、S3-S4级组； 比较三组RTE指标[弹性评分、剪切波速 度(SWV)]、DWI指标[表观扩散系数(ADC) 值]检测结果差异；经Spearman相关系数 分析CHB患者肝纤维化分级与弹性评分、 SWV值、ADC值的相关性。结果 三组患者 弹性评分、SWV值均显示：S0级组＜S1-S2 级组＜S3-S4级组(P均＜0.05)；ADC值则 显示：S0级组＞S1-S2级组＞S3-S4级组。 Spearman相关系数分析显示，CHB患者肝 纤维化分级与弹性评分、SWV值均呈正相 关，与ADC值呈负相关(P均＜0.05)。结论 RTE的弹性评分、SWV值及DWI的ADC值均与 CHB患者的肝纤维化分级关系密切，具有 一定鉴别诊断价值。

Objective To compare the clinical value between real-time ultrasound elastography (RTE) and magnetic resonance diffusion weighted imaging (DWI) in the grading of liver fibrosis in patients with chronic hepatitis B (CHB). Methods 88 cases of patients with CHB were selected as subjects, and they were examined by RTE and DWI. Based on the pathological findings of liver biopsy, 88 patients were divided into S0 group, grade S1-S2 group and grade S3-S4 group. The RTE indexes [elasticity score, shear wave velocity (SWV)] and DWI index [apparent diffusion coefficient (ADC)] were compared among the three groups. The correlations between grade of liver fibrosis and elasticity score, SWV value and ADC value in patients with CHB were analyzed by Spearman correlation coefficient analysis. Results The elasticity scores and SWV values of the three groups showed that the grade S0 group < grade S1-S2 group < grade S3- S4 group (P< 0.05) while ADC values showed that the grade S0 group > grade S1-S2 group > grade S3-S4 group(P<0.05). Spearman correlation coefficient analysis showed that grade of liver fibrosis in patients with CHB was positively correlated with elasticity score and SWV value, and negatively correlated with ADC value(P<0.05). Conclusion The elasticity score, SWV value and ADC value of RTE are closely related to the grade of liver fibrosis in patients, which can be used for differential diagnosis.