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Table of Content

    28 February 2025, Volume 30 Issue 2
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    Viral Hepatitis
    The characteristics of severe jaundice caused by acute hepatitis E and the construction of a warning model
    YUAN Min, XU Shan, MA Jiao-jiao
    2025, 30(2):  165-169. 
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    Objective To explore the characteristics of severe jaundice caused by acute hepatitis E and to construct an early warning model. Methods This is a retrospective analysis of the medical records of 122 patients with acute hepatitis E who received treatment at the Second Affiliated Hospital of Air Force Medical University from January 2021 to January 2023. According to the 80/20 law, they were randomly divided into a training set (N=96 cases) and a validation set (N=26 cases). The patients were divided into a severe group and a mild to moderate group based on whether they occurred severe jaundice during hospitalization. The risk factors for severe jaundice in acute hepatitis E were analyzed, and a warning model for severe jaundice in acute hepatitis E patients were constructed and verified. Results Among the 96 cases of acute hepatitis E, 42 cases developed severe jaundice, with an incidence rate of 43.75% (42 cases/96 cases). 18 cases exhibited obvious symptoms such as fever, poor appetite, muscle soreness, abdominal distension, and vomiting; 54 cases (56.25%) of patients had mild to moderate jaundice. The proportion of liver failure in the severe group was higher than that in the mild to moderate group (P<0.05). The baseline, total bilirubin (TBil) peak, creatinine peak, neutrophil peak, alpha fetoprotein (AFP), and liver elasticity, the value of anti-hepatitis E virus immunoglobulin M antibody (HEV IgM) in the severe group were higher than those in the mild to moderate group (P<0.05). Anti-HEV IgM baseline (OR=3.564, 95% CI=1.751~7.255), peak TBil (OR=3.778, 95% CI=1.856~7.687), peak creatinine (OR=3.688, 95% CI=1.812~7.506), peak neutrophil count (OR=4.216, 95% CI=2.072~8.582), and AFP (OR=4.559, 95% CI=2.239~9.278) are risk factors for severe jaundice in acute hepatitis E (P<0.05). The sensitivity of the risk model for predicting severe jaundice in acute hepatitis E in the training set was 0.827 (95% CI=0.735~0.941), the specificity was 0.834 (95% CI= 0.715~0.941), and the area under the curve was 0.843 (95% CI=0.731~0.928). The sensitivity of the risk model prediction validation set for severe jaundice in acute hepatitis E was 0.731 (95% CI=0.625~0.901), the specificity was 0.828 (95% CI= 0.713~0.947), and the area under the curve was 0.831 (95% CI=0.728~0.951). Conclusion Anti HEV-IgM baseline, TBil peak, creatinine peak, neutrophil peak, and AFP level are associated with severe jaundice in acute hepatitis E. The Construction of an early warning model may help to identify the risk of severe jaundice in acute hepatitis E patients.
    An evaluation of the clinical treatment effect on chronic hepatitis B optimized for HBV RNA
    PENG Min, KAN Jun-ze, GAO Hui, KAN Xiao
    2025, 30(2):  170-174. 
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    Objective To explore the effect of HBV RNA optimized therapy in the clinical treatment of chronic hepatitis B patients after HBV DNA serum disappearance, and to analyze the feasibility of this treatment by comparing with the serological markers of patients received traditional treatment. Methods A total of 118 patients with chronic hepatitis B were included in this study. They were treated with entecavir in early stage. After the patients' serum HBV DNA turned negative, the control group was continuously treated with entecavir, and the experimental group was treated with PEG-interferon α-2b. The data of serum makers in different treatment stages were collected, and the effects of different treatment methods were compared by comparing the alteration and negative conversion rates of HBsAg and HBeAg between the two groups. Results The monthly average decrease in serum HBsAg and HBeAg levels of patients in the experimental group were higher than those in the control group during each treatment period, and the decrease rates were higher than those in the control group after treatment. After 1 month of interferon treatment in the experimental group of patients, the serum HBsAg and HBeAg decreased by 191.8 IU/mL and 8.39 COI, respectively. After 3 months of treatment, the serum HBsAg and HBeAg decreased by 110.9 IU/mL and 2.61 COI, respectively, with faster rates than those of the control group (P<0.05). After 48 weeks of treatment, the HBsAg and HBeAg conversion rates in the experimental group were 14.7% and 27.8%, respectively, which were higher than those of the control group (P<0.05). Conclusion In the treatment of chronic hepatitis B, HBV RNA as well as HBV DNA are therapeutic indicators that are worthy of attention. The levels of serum HBsAg and HBeAg can be significantly reduced by treating HBV RNA when HBV DNA has turned negative, and some patients can reach the requirement of clinical cure.
    Dynamic changes of serum HBV pgRNA and HBcrAg in patients with chronic hepatitis B after discontinuation of NAs therapy: assessment of clinical and virology relapse
    LU Shi, ZHANG Zhi-hong, OUYANG Hui, HE Yu
    2025, 30(2):  175-179. 
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    Objective To observe the value of dynamic changes of serum markers such as hepatitis B virus pregene RNA (HBV pgRNA) and hepatitis B core associated antigen (HBcrAg) in the evaluation of the clinical and virological recurrence in chronic hepatitis B (CHB) patients after discontinuing nucleoside (acid) analogues (NAs) treatment. Methods Between July 2020 and July 2021, sixty-five patients with CHB were admitted to our hospital. All patients met the criteria for discontinuation of NAs therapy, and were followed up for at least half a year after discontinuation. Serum levels of HBV pgRNA, HBcrAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBil) were detected. Results Patients with a family history of HBV infection (70.4%) had a higher recurrence rate than those without (30.8%). Patients with serum HBV pgRNA levels ≥ 4.06 log10copies/mL (79.2%) had a higher recurrence rate than patients with<4.06 log10copies/mL (41.5%). Patients with serum HBcrAg levels ≥ 3.4 log10 U/L (76.9%) had a higher recurrence rate than patients with<3.4 log10 U/L (41.0%), The recurrence rate (46.0%) of patients with hepatitis B E antigen (HBeAg) disappearance within 12 months was lower than that of patients with HBeAg disappearance within 12 to 24 months (88.9%, 83.3%), and the recurrence rate (46.0%) of patients with serological HBeAg conversion within 12 months was lower than that of patients with HBeAg disappearance within 12 to 24 months (88.9%, 83.3%), The recurrence rate of patients with hepatitis B B surface antigen (HBsAg)<150 ng/mL (26.3%) was lower than that of patients with HBsAg≥ 150 ng/mL (67.4%) (P<0.05). HBeAg serological conversion time, family history of HBV infection, HBeAg disappearance time, HBsAg level, serum HBV pgRNA level and serum HBcrAg level at the time of drug withdrawal were all influential factors for clinical and virologic recurrence in CHB patients who stopped NAs treatment (P<0.05). HBeAg serological conversion time, family history of HBV infection, HBsAg level at drug withdrawal, serum HBV pgRNA level, and serum HBcrAg level were all risk factors for clinical and virologic recurrence in CHB patients who stopped NAs treatment (P<0.05). Conclusion The risk factors for clinical and virological recurrence in CHB patients who have stopped NAs therapy are HBeAg serological conversion time, family history of HBV infection, HBsAg level, serum HBV pgRNA level and serum HBcrAg level at the time of drug withdrawal. Clinical measures should be taken accordingly. The HBsAg level, serum HBV pgRNA level and serum HBcrAg level should be monitored regularly to reduce the recurrence rate of CHB patients.
    Liver Fibrosis & Cirrhosis
    The improvement of preoperative hypersplenism in patients with end-stage liver diseases following liver transplantation
    XIANG Lu, LI Jing, ZHANG Da-li, LIU Jia, ZHANG Xiao-feng
    2025, 30(2):  180-182. 
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    Objective To explore the improvement of preoperative hypersplenism in patients with end-stage liver diseases (ESLD) following liver transplantation. Methods The data of 156 ESLD patients who underwent liver transplantation from March 2015 to March 2019 were investigated. All patients were classified into a severe splenomegaly group (N=65) and a splenomegaly group (N=91) based on whether their spleen diameter ≥170 mm or <170 mm. The improvement of preoperative hypersplenism was compared between these two groups. Results The white blood cell counts were 3.30×109/L and 4.63×109/L (P<0.001), platelet counts were 107.6×109/L and 149.0×109/L (P<0.001), spleen diameters were 150.0 mm and 125.5 mm (P<0.001), and portal hyper-perfusion were 1647 mL/min and 1300 mL/min (P=0.001) in patients with severe splenomegaly and splenomegaly, respectively, after one year post liver transplantation. There were significant differences between the two groups. Conclusion Patients with severe splenomegaly had lower white blood cell and platelet counts and more severe portal hyper-perfusion compared to those patients with splenomegaly.
    A prediction model of mortality risk after interventional operation on cirrhotic portal hypertensive patients complicated with esophagogastric varices rupture and hemorrhage
    MA Zhi-gang, LIU Li-li, WANG Xu, FENG Peng-li, YANG Fan, YANG Yong-bin
    2025, 30(2):  183-186. 
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    Objective To explore a model for predicting the risk of death following intervention therapy in cirrhotic portal hypertensive (PHT) patients complicated with esophageal and gastric varices bleeding (EGBV). Methods One hundred and twelve patients with PHT complicated with EGBV admitted to our hospital from January 2020 to December 2021 were selected. All patients were treated with intrahepatic portal vein shunt via jugular vein for intervention therapy. After 1 year's follow-up, the patients were divided into a survival group (N=88 cases) and a death group (N=24 cases). The influencing factors of postoperative death were analyzed by univariate and multivariate COX regression method, and a prediction model for the risk of death was built. Results One year after interventional jugular intrahepatic portal vein shunt operation, 88 cases (78.57%) survived. In the death group, the average of portal vein diameter was (15.37±5.48) mm; the ratio of cases with Child Pugh grade B and C was 91.67% (22/24), with hepatic encephalopathy was 66.67% (16/24). The ratio of hemorrhagic shock was 45.83% (11/24), the level of alpha-fetoprotein was (6.14±1.23)μg/L, and the average of MELD score was (16.74±2.13), which were higher than those of 68.118% (60/88), (4.22±1.35) μg/L, and (13.38±2.49) in the survival group. The levels of Serum creatinine (1.42±0.39) μmol/L and albumin (31.46±4.38)g/L in the death group were lower than those of (1.76±0.58)μmol/L and (35.32±5.27)g/L in the survival group (P<0.05). Multivariate COX regression analysis showed that portal vein diameter≥14.26mm {(Hazard Ratio (HR)=2.237, 95%CI=1.381~3.622), combined with hepatic encephalopathy (HR=1.671, 95%CI=1.671~5.745), hemorrhagic shock (HR=2.784, 95%CI=1.746~4.439) and MELD score≥15 points (HR=2.552, 95%CI=1.906~3.418) were independent risk factors for postoperative death in cirrhotic patients with intervention therapy for PHT complicated with EGBV (HR>1, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve of the predictive model for postoperative death was 0.86 (95%CI=0.734~0.923), and the sensitivity and specificity were 83.25% and 68.76%, respectively. Conclusion Portal vein diameter ≥14.26mm, hepatic encephalopathy, hemorrhagic shock, MELD score ≥15 points were independent risk factors for postoperative death in cirrhotic patients after intervention therapy for PHT complicated with EGBV, and the prediction model for postoperative death built on these risk factors had good predictive value.
    A network calculator based on the platelet index score effectively predicts the prognosis of patients with decompensated cirrhosis
    ZHANG Ming-xing, ZHUANG Wen-qiong, SHI Li-min, CAI Si-qi
    2025, 30(2):  187-192. 
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    Objective A network calculator based on platelet index score (PIS) was constructed to predict the death risk within 6 months in patients with decompensated liver cirrhosis. Methods One hundred and eighty-two patients with decompensated cirrhosis treated from January 2021 to January 2023 were selected. PIS was constructed based on the subjects' working characteristics (ROC) curves. The independent prognostic factors for the risk of death from decompensated cirrhosis were analyzed using univariate and multivariate Cox regression models. And R packages such as rms, foreign, readxl, Hmisc, and rmda were used to construct and evaluate nomogram predictive accuracy. The DynNom package was used to develop a network calculator for the risk of disease and death in patients with decompensated cirrhosis. Results The 6-month mortality rate was 36.8% in 182 patients. The area under the curve (AUC) for PIS to predict the death risk of the patients was 0.837 (95% CI=0.776~0.888). The results of multifactorial Cox risk regression analysis showed that age, proportion of diabetes, MELD score, Alb, NLR and PIS were independent prognostic factors for the risk of disease and death within 6 months in patients with decompensated cirrhosis (P<0.05). The best cut-off values for age, diabetes, MELD score, Alb, NLR and PIS were classified into high- and low-risk groups based on ROC curve analysis to assess the survival curves of patients with decompensated cirrhosis and to construct nomogram of the risk of disease and death at 28 days, 3 months and 6 months in patients with decompensated cirrhosis. The calibration curves showed that the AUC values of the nomogram for predicting the death risk at 28 days, 3 months and 6 months were 0.852 (0.804~0.942), 0.935 (0.879~0.985) and 0.863 (0.812~0.953), respectively, which demonstrated that the nomogram had excellent predictive efficacy. Time-Decision Curve Analysis (DCA) showed that the nomogram provided clinically significant net benefits at the 28-day, 3-month, and 6-month time points. The network calculator interface is available at website (https://nomogram1203.shinyapps.io/Dynamic-sui/). Conclusion A network calculator developed based on PIS effectively predicts the risk of death within 6 months in patients with decompensated cirrhosis.
    The application of instantaneous elastography, APRI and portal vein width in evaluating the severity of liver cirrhosis
    ZHANG Cui-lu, LU Hui-ling, ZHANG Han-zhou
    2025, 30(2):  193-196. 
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    Objective To analyze the value of transient elastography, aspartate aminotransferase (AST) -platelet ratio (PLT) (APRI) index and portal vein width in evaluating the severity of liver cirrhosis. Methods Seventy-five patients with liver cirrhosis admitted to Yingde People's Hospital of Guangdong Province from July 2021 to June 2024 were selected. Before treatment, portal vein width was measured by abdominal computed tomography (CT) and liver stiffness measurement (LSM) was performed by instantaneous elastic imaging technology. The aspartate aminotransferase (AST) and platelet (PLT) levels of patients were collected and APRI index was calculated. The Child-Pugh scoring standard was adopted, and the grades were scored and graded through various imaging examinations and laboratory examinations. Grade A and B patients were included in the mild to moderate group, and grade C patients were included in the severe group. By comparing the basic data of patients in the severe group and the mild to moderate group, the influencing factors and value of instantaneous elastography, APRI and portal vein width in evaluating the severity of cirrhosis were analyzed, and the correlation between instantaneous elastography, APRI, portal vein width and the severity of cirrhosis was analyzed. Results In the study involving 75 patients with cirrhosis, the severity of the condition was categorized into three groups: 18 patients with severe cirrhosis, 26 with moderate cirrhosis, and 31 with mild cirrhosis. The APRI level, LSM level, and portal vein diameter were significantly higher in the severe group when compared to the mild and moderate groups (P<0.05). Specifically, LSM {odds ratio (OR)=2.740, 95% CI=1.564~4.801}. and APRI level (OR=17.500, 95%CI=2.253~135.922), portal vein width (OR=18.962, 95%CI=3.056~117.653) were the influential factors in predicting the severity of cirrhosis (P<0.05). According to receiver operating characteristic (ROC) curve analysis, the sensitivity of APRI, portal vein width, LSM and combined assessment of the severity of cirrhosis were 61.10%, 61.10%, 72.20% and 88.90%, respectively, and the specificity were 68.40%, 75.40%, 71.90% and 70.20%, respectively. The combination of APRI, portal vein width and LSM had a high value in predicting the severity of cirrhosis (AUC=0.922). Pearson correlation analysis showed that the values of APRI, LSM and portal vein width were positively correlated with the severity of cirrhosis (P<0.05). Conclusion The instantaneous elastic imaging technique, APRI index and portal vein width are correlated with the severity of cirrhosis, and the combined detection has a higher value in predicting the severity of cirrhosis.
    Evaluation of the combined detection of liver ultrasound blood flow parameters and liver-spleen stiffness in predicting esophageal variceal bleeding in hepatitis B cirrhosis patients
    WANG Xian, LI Liang, WU Xin-yong, WANG Si-si
    2025, 30(2):  197-200. 
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    Objective To investigate the predictive value of liver ultrasound blood flow parameters combined with liver-spleen stiffness detection in predicting esophageal variceal bleeding in patients with hepatitis B cirrhosis. Methods From August 2021 to March 2024, 100 patients with hepatitis B cirrhosis treated at the Second People's Hospital of Lianyungang were selected for this study. Based on whether they experienced esophageal variceal bleeding during the follow-up period, the patients were divided into a bleeding group (34 cases) and a non-bleeding group (66 cases). All patients underwent Doppler ultrasound, contrast-enhanced ultrasound, and two-dimensional shear wave elastography (2D-SWE) for liver and spleen stiffness measurement. Parameters such as portal vein velocity (PVV), portal vein diameter (PVD), hepatic vein arrival time (HVAT), portal vein congestion index (PV-CI), and liver stiffness values were recorded. Results The bleeding group had lower PVV and HVAT but higher PVD, PV-CI, and liver stiffness values than the non-bleeding group (P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivities of liver stiffness value, PVV, PVD, PV-CI, and HVAT in predicting esophageal variceal bleeding were 44.1%, 64.7%, 76.5%, 52.9%, and 94.1%, respectively, and their specificities were 83.3%, 84.8%, 81.8%, 92.4%, and 86.4%, respectively. The area under the curve (AUC) values were 0.662, 0.810, 0.842, 0.800, and 0.953, respectively. When these parameters were combined, the sensitivity and specificity reached 95.5% and 94.1%, respectively, with an AUC value of 0.982. Conclusion The combined assessment of liver ultrasound blood flow parameters and liver-spleen stiffness measurement can effectively predict the risk of esophageal variceal bleeding in patients with hepatitis B-related cirrhosis, demonstrating significant clinical value. Early identification of high-risk patients allows for timely preventive interventions, reducing the risk of bleeding and improving patient outcomes.
    Objective prediction of esophageal variceal bleeding risk in hepatitis b cirrhosis based on shear wave elastography and venous hemodynamic parameters using logistic regression model
    CHEN Hui-qin, WANG Shuang, HAN Yu
    2025, 30(2):  201-206. 
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    Objective To investigate the application value of shear wave elastography (SWE) and venous hemodynamic parameters in predicting the risk of esophageal variceal bleeding (EVB) in patients with Hepatitis B virus (HBV) cirrhosis. Methods A total of 126 patients with HBV cirrhosis admitted to our hospital from July 2020 to July 2023 were selected as the subjects of this study. Multifactorial regression analysis was employed to identify the risk factors for the occurrence of EVB in patients with HBV cirrhosis, and the predictive value of SWE and venous hemodynamic parameters was assessed using the receiver operating characteristic (ROC) curve. Results Univariate analysis indicated that the proportions of severe varices (61.29)% and the values of MCT (6.50±1.35) s, PET (15.18±2.21) s, LSM (16.54±5.55) kPa, and SSM (32.73±8.70) kPa in the bleeding group were significantly higher than that in the non-bleeding group (severe varices proportion 41.05)%, MCT (4.37±1.46) s, PET (12.53±2.95) s, LSM (13.14±4.95) kPa, SSM (25.14±8.59) kPa, while PLT levels (75.20±21.37) × 109/L were lower than that in the non-bleeding group (102.45±26.21) × 109/L (P<0.05). Multifactorial regression analysis revealed that the degree of varices, PLT, MCT, PET, LSM, and SSM were independent risk factors for EVB in patients with HBV-related cirrhosis (P<0.05). ROC curve analysis demonstrated that the combination of MCT, PET, LSM, and SSM parameters had an AUC of 0.957, with a sensitivity of 90.3% and a specificity of 92.6%. Conclusion The measurements of MCT, PET, LSM, and SSM are closely related to the risk of EVB in HBV patients with cirrhosis and can serve as effective predictive assessment indicators.
    Evaluation of hepatic blood perfusion parameters using spiral CT after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension
    DU Xin-yang, SHI Ke
    2025, 30(2):  207-210. 
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    Objective To evaluate the hepatic blood perfusion after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatitis B cirrhosis and portal hypertension by using the hepatic blood perfusion parameters of spiral CT. Methods Between January 2020 and January 2024, 116 patients with hepatitis B cirrhosis complicated with portal hypertension were scanned with whole liver perfusion CT before and 1 week after TIPS. The image quality was evaluated and the changes of CT perfusion parameters was calculated by post-processing workstation. After a 6-month follow-up, the differences of CT perfusion parameters in patients with portal hypertension due to hepatitis B cirrhosis in different prognosis were compared. Results Hepatic artery perfusion (HAP), portal vein perfusion (PVP), total hepatic perfusion (THP) and hepatic artery perfusion index (HAPI) [1]in patients with hepatitis B cirrhosis complicated with portal hypertension were significantly different from those before TACE (P<0.05). The levels of alanine aminotransferase (ALT), albumin (Alb), total bilirubin (TBil) and prothrombin time (PT) in patients with hepatitis B cirrhosis complicated with portal hypertension were (32.1±7.4) U/L, (33.1±1.0) g/L, (17.3±2.9) μmol/L and (12.2±0.6) s at 1 week after TACE, compared with the patients in preoperative TACE group [(42.8±8.9) U/L, (32.0±1.1) g/L, (32.6±6.2) μmol/L and (13.4±1.0) s]. The difference was statistically significant (P<0.05). After following up for 6 months, 17 (14.6%) of the 116 patients died, including 6 (35.3%) from gastrointestinal bleeding and 11 (64.7%) from hepatic encephalopathy. HAP, PVP, THP and HAPI in death group were (23.1±11.6) mL/min × 100 mL, (38.0±14.3) mL/min × 100 mL and (54.7±19.3)%, their parameter were significantly lower than those in the survival group [(30.2±8.9) mL/min × 100 mL, (46.2±8.5) mL/min × 100 mL and (67.0±14.1)%, respectively, P<0.05]. Conclusion CT perfusion imaging was used to evaluate the changes of perfusion parameters before and after TIPS in patients with portal hypertension due to hepatitis B cirrhosis, and to understand the hemodynamic differences, so as to provide reference for preoperative and curative effect evaluation of patients.
    Liver Cancer
    Application of contrast-enhanced ultrasound combined with serum alpha fetoprotein (AFP) and amyloid A/C-reactive protein (SAA/CRP) levels in the differential diagnosis of hepatocellular adenoma and carcinoma
    WANG Qian, LIANG Shuang, LI Jing, XU Jia-qi, WANG Fang-xu
    2025, 30(2):  211-215. 
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    Objective To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) combined with serum alpha fetoprotein (AFP) and serum amyloid A/C-reactive protein (SAA/CRP) levels in distinguishing between hepatocellular adenoma (HCA) and hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on 119 patients treated in Qinhuangdao Traditional Chinese Medicine Hospital from March 2020 to June 2023. Among them, 60 were HCC patients,(28 with high differentiation and 32 with low differentiation), and 29 were HCA patients. Among them, 10 were HNF1a mutant (H-HCA) patients, 10 were β- Catenin mutant with HCA, and 9 were inflammatory HCA type (IHCA). We compared the CEUS parameters (starting time, starting intensity, peak time, and peak intensity) of all patients underwent CEUS examination. Serum AFP, SAA, and CRP levels were measured using enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curves and COX multivariate analysis were performed to evaluate the combination of CEUS, AFP, and SAA/CRP levels in diagnosing HCA and HCC. Results CEUS parameters (onset time, peak time, and peak intensity) in HCC group were lower than that in HCA group (P<0.05), and SAA/CRP levels could distinguish between HCA and HCC; The level of biomarkers can reflect the differentiation degree of HCC, showing high sensitivity and specificity; The combination of CEUS with AFP and SAA/CRP levels showed the highest diagnostic efficacy in the detection of HCA and HCC, with an area under the curve of 0.953, sensitivity of 93.1%, specificity of 90.0%, and a Yoden index of 0.831, which achieved better diagnostic efficacy than using a single indicator; Multivariate COX analysis showed that the onset time, onset intensity, peak time and intensity, AFP and SAA/CRP levels were all factors affecting the diagnosis of HCA and HCC (P<0.05). Conclusion CEUS combined with the serum AFP and SAA/CRP provides a higher accurate method for the differential diagnosis of HCA and HCC. The high sensitivity and specificity of this combination method may have a significant impact on clinical decision-making and patient treatment choice.
    The value of combining the MRI manifestations of pumeixian liver bile stage donut nodules with DCE-MRI perfusion quantitative parameters in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma
    LI Yun-hua, GAO Xin-yang
    2025, 30(2):  216-221. 
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    Objective To explore the value of magnetic resonance imaging (MRI) combined with dynamic contrast-enhanced MRI (DCE-MRI) perfusion quantitative parameters in evaluating the efficacy of transcatheter arterial chemoembolization(TACE) in hepatocellular carcinoma (HCC) during the hepatobiliary phase. Methods Retrospective analysis of the medical records of 86 HCC patients treated with TACE at Changzhou Third People's Hospital between January 2018 and January 2023. Record the MRI manifestations and DCE-MRI perfusion quantitative parameters of the hepatic and biliary phase donut nodules before transcatheter hepatic arterial chemoembolization treatment, including the vascular permeability constant (Kt), blood reflux constant (Kep), and percentage of extracellular space volume (Ve) at the maximum level of the lesion. After hepatic artery chemoembolization treatment, the efficacy was evaluated according to the solid tumor evaluation standard 1.1 (RECIST 1.1) and divided into stable group and progressive group. Analyze the influencing factors of the efficacy of TACE in HCC patients. Evaluate the predictive efficacy of MRI manifestations of hepatic biliary doughnut nodules and DCE-MRI perfusion quantitative parameters in predicting the efficacy of TACE in HCC patients. Results Among 86 HCC patients treated with hepatic artery chemoembolization, 46 (53.49%) progressed and 40 (46.51%) remained stable. Before undergoing hepatic arterial chemoembolization treatment, the MRI liver biliary phase scan results showed that among 86 HCC patients, 35 (40.70%) had hepatic biliary doughnut nodules, and the arterial phase showed high enhanced signal, with 45 (52.33%) showing low signal and 6 (6.98%) showing high signal. The sensitivity, specificity, positive predictive value, and negative predictive value of Pu Mei Xian's hepatic biliary phase donut nodule MRI in predicting the efficacy of TACE were 76.09%, 100.00%, 100.00%, and 78.43%, respectively. The ΔKt of patients in the progression group and stable group were (0.22 ± 0.07) and (0.31 ± 0.09), respectively, with ΔKep of (0.57 ± 0.12) and (0.39 ± 0.10). The △Kt of patients in the progressive group was lower than that in the stable group, while △Kep was higher than that in the stable group (P<0.05). There was no statistically significant difference in △Ve between the two groups (P>0.05). The total bilirubin (TBil), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in the progressive group were higher than those in the stable group (P<0.05). TBil, ALT, AST, ΔKt, ΔKep, and the appearance of sweet doughnut nodules in the hepatobiliary phase of Pramiphene are risk factors for HCC progression (P<0.05). The MRI manifestations of the liver and gallbladder phase donut nodules in Pumeixian, as well as the AUC of single and combined prediction of HCC progression with △Kt and △Kep, were 0.880, 0.750, 0.748, and 0.887, respectively. Conclusion The MRI manifestations of Pumeixian hepatobiliary doughnut nodules and the changes in Kt and Kep during DCE-MRI perfusion are related to the treatment response of HCC patients to TACE, and can be used to predict the therapeutic effect.
    Analysis of the efficacy and safety of radioactive strontium chloride (89Sr) combined with zoledronic acid in treating primary liver cancer with bone metastasis
    FU Qin-qing, YUAN Qin-shi, YANG Xia-xin
    2025, 30(2):  222-225. 
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    Objective To explore the efficacy and safety of radioactive strontium chloride (89Sr) combined with zoledronic acid in treating primary liver cancer with bone metastasis. Methods A total of 100 patients with primary liver cancer bone metastasis were prospectively selected and randomly separated into two groups. The zoledronic acid group was treated with zoledronic acid, while the combination group was treated with 89Sr combined with zoledronic acid. The efficacy and safety of the two groups were compared. Results The total effective rate of the combined group was 74.00% (37/50), which was greatly higher than that (54.00% (27/50) in the zoledronic acid group (P<0.05). After treatment, the visual analogue scale (VAS) score (2.65±0.76) in the combination group was lower than that in the zoledronic acid group (3.83±1.13) score, and the Karnofsky performance scale (KPS) (82.16±8.29) was higher than that in the zoledronic acid group (75.82±7.85), with statistical significance(P<0.05). The start time [(2.62±0.37) d] of bone pain relief in the combination group was earlier than that in the zoledronic acid group [(3.27±0.42) d], and the duration of bone pain relief [(4.09±0.44) month] was longer than that in the zoledronic acid group [(3.06±0.36) month] (P<0.05). After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), serum calcium (Ca2+), type 1 collagen amino terminal elongation peptide (TPINP), and alkaline phosphatase (AKP) in the combination group were lower than those in the zoledronic acid group (P<0.05). The overall incidence of treatment-related adverse reactions in the combination group was 30.00% (15/50), which was not greatly different from the 20.00% (10/50) in the zoledronic acid group (P>0.05). Conclusion For patients with primary liver cancer bone metastasis, the combined treatment of 89Sr+zoledronic acid has a more great effect. It can promote pain relief, eliminate inflammatory reactions, improve physical condition and bone metabolism with a good safety.
    Risk factors for pulmonary metastasis in patients with hepatocellular carcinoma
    LUO Xiao-wei, ZHOU Li-jiang, XU Chong
    2025, 30(2):  226-230. 
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    Objective To evaluate the risk factors and serological indexes related to lung metastasis in patients with hepatocellular carcinoma (HCC), and to provide reference for early diagnosis and treatment of HCC lung metastasis and improvement of prognosis. Methods A total of 128 HCC patients admitted to Xishan District Hospital of Traditional Chinese Medicine of Wuxi City from January 2020 to December 2023 were involved and divided into lung metastasis group (n=37) and no lung metastasis group (n=81) according to whether lung metastasis occurred within 2 years of diagnosis and treatment. The baseline data and clinical indicators of the subjects were collected and compared, and the risk factors of lung metastasis in HCC were analyzed by logistic multivariate regression. The receiver operating curve (ROC) was plotted to analyze risk factors and the estimated value of the predictive model. Results The preoperative history of CHB, tumor diameter > 5 cm, number of tumors > 2, presence of PVTT and cirrhosis, proportion of non-operative treatment and NLR, ALBI, AFP-L3 and PIVKA-Ⅱ levels were 72.97%, 51.35%, 56.76%, 67.57%, 59.46% and 70.27, respectively %, 0.29, -1.86, 95.49±11.27 μg/L, 548.16±65.34 mAU/mL, They were higher than those in the group without lung metastasis (51.85%, 29.63%, 33.33%, 34.57%, 37.04, 53.09%, 0.42, -3.28, 45.16±6.45 μg/L, 207.35±26.09 mAU/mL), and the difference was statistically significant (t/χ2/Z=3.762, 4.084,3.917,4.526, 4.073, 3.659, 7.268, 9.436, 11.264, 13.538 were all P<0.05). Logistics regression analysis showed that CHB history and PVTT existed before surgery, increased levels of NLR, ALBI, AFP-L3 and PIVKA-Ⅱ were independent factors for lung metastasis in HCC patients (95%CI: 0.905 ~ 1.126, 0.751 ~ 0.863, 0.816 ~ 1.274, 0.875 ~ 1.427, 1.034 ~ 1.568, 0.843 ~ 1). 369, OR=0.934, 0.803, 1.024, 1.126, 1.359, 1.107, all P<0.05). ROC analysis showed that the area under the curve (AUC) of preoperative CHB history and PVTT, NLR, ALBI, AFP-L3 and PIVKA-Ⅱ levels were 0.709, 0.725, 0.817, 0.810, 0.881 and 0.852, respectively. The sensitivity was 70.27%, 81.08%, 86.49%, 83.78%, 94.59%, 89.19%, and the specificity was 64.86%, 67.57%, 78.38%, 72.97%, 83.78%, 91.89% (all P<0.01). Conclusion Preoperative history of CHB and abnormal elevation of PVTT, NLR, ALBI, AFP-L3 and PIVKA-Ⅱ levels in HCC patients are independent risk factors for lung metastasis, which can provide a reference for early warning, diagnosis and treatment and prognosis evaluation.
    Other Ljiver Diseases
    Case-control study on the efficacy and safety of nafamostat mesylate and heparin in double plasma molecular absorption system
    WANG Xin-yue, Zhou Li, CHEN Yu
    2025, 30(2):  231-235. 
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    Objective This case-control study was conducted to compare the anticoagulant efficacy and safety of nafmostat mesylate (NM) and heparin (HP) during double plasma molecular absorption system (DPMAS) treatment. Methods 103 patients with hyperbilirubinemia were included in You'an Hospital affiliated to Capital Medical University between April 2022~March 2024 using prospective case-control research methods, and were divided into NM group and HP group with NM or HP in vitro anticoagulation during DPMAS treatment. Laboratory indicators, including total bilirubin (TBil), platelet(PLT) count, prothrombin activity(PTA) and partial thromboplastin time (APTT)were collected before and after DPMAS treatment, and complications such as various pressure parameters, alarms, bleeding or blockage during treatment. Results Out of the 103 DPMAS treatments, the procedure successfully completed in 102(99. 0% ), with only one treatment being discontinued because of plugged pipes induced by insufficient anticoagulation of HP; the satisfactory anticoagulation rate in NM-managed group was 88.2%, significantly higher than the 37.3% observed in HP-intervened group, and the over anticoagulation rate was 3.9%, much lower than the 58.8%(P<0.05) observed in HP-intervened group; During the treatment, the difference between the APTT at the venous and arterial end of the cardiopulmonary bypass line in the NM group [247(110, 286.3) vs. 0.0(0. 0, 55.5) s, P<0.05] significantly larger than the HP group; there were no significant differences in serum bilirubin, albumin levels and platelet counts between the two groups [(164.8±62.6) μmol/L, 5.7 (4.7, 7.8) g/L and 21 (11.5, 33.5) ×109/L, vs. (174.3±64.9) μmol/L, 6.5 (5.1, 8.7) g/L and 15 (6, 24) ×109/L, respectively, P>0.05]; During the course of treatment, severe pipe blockage was found in 1 case in HP anticoagulant group , the puncture skin haemorrhage was observed in 1 case in HP anticoagulant group, 1 case in the NM group, and transient increased transmembrane pressure, or venous pressure or coagulation alert by the machine occurred in 4 cases in NM anticoagulant group. Conclusion In the process of DPMAS treatment, NM demonstrates a better anticoagulation effect and higher safety compared to HP, which is worthy of further discussion. However, for patients with PTA≤40%, the optimal dose of NM requires further investigation.
    Succinic acid alleviates obesity and fatty liver disease induced by high fat diet in mice
    XU Yi-qing, CHEN Yuan, CUI Wen-qi, ZHANG Xue-min
    2025, 30(2):  236-239. 
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    Objective To explore the alleviative effect of succinic acid on weight gain, elevated blood lipids and blood sugar, and concurrent hepatic steatosis in mice induced by the high-fat diet. Methods Thirty mice were divided into control group, high-fat diet group and succinic acid-treated high-fat diet group with 10 mice in each group by block random method. The body weight of mice in each group was measured at the beginning of the experiment and subsequently every week. Comparisons between groups were carried out. After 11 weeks of feeding, the levels of serum total cholesterol (TC), triglyceride (TG), blood glucose (GLU) and aspartate transaminase (AST) were measured and compared between each group. Mice were sacrificed and livers were weighed to calculate the liver index. The mesenteric fat of each group was also weighed. The livers of mice in each group were stained with hematoxylin-eosin (HE) method, the morphology of liver cells was observed under the microscope to assess the severity of fatty liver. Results Compared with the control group, the body weight of mice in high-fat diet group and the succinic acid-treated high-fat diet group significantly increased after 1 week of feeding (all P<0.05). After 2 and 3 weeks of feeding, the body weight of mice in high-fat diet group and the succinic acid-treated high-fat diet group mice were significantly increased compared with that of control group (all P<0.05). However, the body weight of mice in the succinic acid-treated high-fat diet group were significantly lower than that in the high-fat diet group (P<0.05). After the 4th week to the 11th week, the body weight of mice in the high-fat diet group were significantly higher than that in the control group (all P<0.05), and the body weight of the mice in succinic acid-treated high-fat diet group were significantly lower than that in the high-fat diet group (all P<0.05). After 11 weeks of feeding, the levels of serum TC, TG, GLU and AST in the high-fat diet group mice were increased significantly compared with the control group (all P<0.05). The levels of serum TC, TG, GLU and AST in the succinic acid-treated high-fat diet group were significantly lower than those in the high-fat diet group (all P<0.05). The liver index and mesenteric fat weight in the high-fat diet group were significantly increased compared with the control group (all P<0.05), and the liver index and mesenteric fat weight of mice in the succinic acid-treated high-fat diet group were significantly lower than those in the high-fat diet group (all P<0.05). HE staining showed that the liver cells of mice in the high-fat diet group had obvious steatosis, while the liver cells steatosis of mice in the succinic acid-treated high-fat diet group were significantly alleviated compared with that in the high-fat diet group. Conclusion The succinic acid can significantly alleviate the weight gain caused by high-fat diet in mice, reduce the levels of TC, TG, GLU, AST in the high-fat diet mice, and alleviate fatty liver disease.
    Rucotinib combined with artificial liver for severe hepatic graft-versus-host disease with poor glucocorticoid response:A report of 3 cases
    ZHOU Xing-nian, ZHAO Peng, GAO Ting, ZHANG Quan, LI Hong
    2025, 30(2):  240-244. 
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    Objective To observe the efficacy of Rucotinib combined with artificial liver in the treatment of 3 cases of severe liver graft-versus-host disease(GVHD) with poor glucocorticoid response. Methods A total of 3 patients with severe liver graft-versus-host disease after allogeneic hematopoietic stem cell transplantation were retrospectively collected from January 2017 to December 2021 in the Infectious disease Department of Affiliated Hospital of Guizhou Medical University. All 3 patients were treated with Rucotinib combined with artificial liver, and received active infection prevention and symptomatic treatment. Results Three patients with severe liver GVHD were treated with Rucotinib combined with artificial liver PE and DPMAS, and the liver function was significantly improved and the prognosis was favorable. Conclusion The prognosis of liver graft-versus-host disease is poor, and early diagnosis and treatment are essential. The abnormal elevation of ALP and glutamyltranspeptide before total bilirubin after allogeneic hematopoietic stem cell transplantation may serve as an important early warning indicator of chronic liver GVHD. Early treatment with rucotinib can improve the over-activation of immune system, reduce the damage of bile duct epithelial cells, thereby reducing liver damage, avoiding artificial liver treatment, and prolonging the survival time of patients.
    Analysis of the effect of chemical cholecystectomy on cholecystitis after biliary stent implantation
    YANG Xiao-bin, JIANG Jin-quan
    2025, 30(2):  245-248. 
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    Objective To analyze the high-risk factors, characteristics of inflammatory markers, and predictive value of IL-6 and PCT in diagnosing cholecystitis after biliary stent implantation in patients with malignant biliary tract tumors. Methods A retrospective analysis was conducted on the clinical data of 205 patients (including 22 cases of postoperative cholecystitis) who underwent percutaneous biliary stent implantation for malignant obstructive jaundice in our hospital from January 2021 to December 2023. High-risk factors for postoperative cholecystitis were analyzed based on factors such as transaminase and bilirubin levels before and one week after surgery, presence of biliary stones or a history of biliary stones, tumor and stent placement in the lower segment of the common bile duct, and visualization of the gallbladder after intraoperative biliary stent implantation. Compare the differences in CRP, PCT, IL-6, and TNF - α between the two groups, and analyze the predictive value of IL-6 and PCT for their diagnosis. Results One week after surgery, the total bilirubin value in the group with concurrent cholecystitis (235.99 ± 145.22) μmol/L was higher than that in the control group (185.28 ± 131.41) μmol/L. The incidence of concurrent cholecystitis combined with biliary stones or a history of biliary stones was 22.73% higher than that in the control group (9.84%). The incidence of concurrent cholecystitis in patients with tumors or stents located in the lower part of the common bile duct was 68.18% higher than that in the control group (19.67%). Logistic analysis of variables showed that tumors and stents located in the lower part of the common bile duct were the main factors affecting the occurrence of cholecystitis after biliary stent implantation (OR=1.176, P=0.016). The ROC curve results showed that at 14.58 pg The sensitivity and specificity of IL-6 in predicting postoperative cholecystitis after biliary stent implantation were 68.2% and 70.0%, with/mL as the cutoff value; With a cut-off value of 4.21ng/mL, the sensitivity and specificity of PCT in predicting postoperative cholecystitis after biliary stent implantation are 50.0% and 96.7%, respectively; The sensitivity and specificity of the combined prediction of cholecystitis after biliary stent implantation are 67.7% and 90.4%, respectively. Conclusion Tumors and stents located in the lower segment of the common bile duct are the main factors affecting the occurrence of cholecystitis after biliary stent implantation. IL-6 and PCT are valuable in predicting its diagnosis, and their combination can better predict the occurrence of cholecystitis after biliary stent implantation.
    Clinical characteristics and therapeutic efficacy of patients with diabetes complicated by bacterial liver abscess
    YAO Na, DONG Peng-gang, CHEN Li, ZHAO Wen-hua, XU Lin-xin
    2025, 30(2):  249-252. 
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    Objective To analyze the typical characteristics of patients with diabetes complicated by bacterial liver abscess and the curative effect of follow-up treatment, so as to provide basis for clinical diagnosis and treatment. Methods A total of 117 patients with bacterial liver abscess who were admitted to Changzhi People 's Hospital Affiliated to Changzhi Medical between November 2019 and May 2023 were included in the study. Patients were divided into two groups based on the presence or absence of diabetes: a diabetic group (n=44) and a non-diabetic group (n=73). The general data, laboratory examination and imaging examination of patients were compared, and the curative effect was evaluated after observation and follow-up. Results Comparing the general data, it was observed that the proportions of chills and abdominal pain in the diabetic group were 43.2% and 65.9% respectively, which were significantly higher than those in the non-diabetic group [23.3% and 35.6% (P<0.05)]; comparing the imaging results, it can be seen that the proportion of patients with multiple abscesses and the proportion of abscesses with a maximum diameter greater than 10cm in the diabetic group were 34.2% and 54.5%, which were significantly higher than those in the non-diabetic group [11.4% and 20.5% (P<0.05)]. The proportion of abscesses with a maximum diameter less than 5cm was 6.8%, significantly lower than the patients in the non-diabetic group (30.1%) (P<0.05); Comparing the laboratory test results, it can be seen that the levels of ALT, AST and TBil in the diabetic group were 247.5 (84.5, 644.9) U/L and 314.1 (164.5, 164.5, respectively). 766.2) U/L and 68.2 (42.7, 135.8) μmol/L, which were significantly higher than those in the non-diabetic group [48.2 (12.3, 134.1) U/L, 42.9 (15.3, 164.5) U/L and 35.1 (10.2, 59.3 ) μmol/L (P<0.05)]; Comparing the efficacy, it can be seen that the procalcitonin recovery time, intravenous antibiotic use time and hospitalization time of more than three weeks in the diabetes group were 8.5 (5.5, 10.5) days and 18.5 (12.0, 12.0, respectively). 22.0) days and 45.5%, which were significantly higher than the non-diabetic group [4.5 (2.5, 6.0) days, 10.0 (8.0, 16.0) days and 21.9% (P<0.05)]. Conclusion Patients with bacterial liver abscess complicated by diabetes have more diverse and severe symptoms and poorer treatment efficacy.
    Analysis of the clinical efficacy and safety of doxycycline and azithromycin in patients with scrub typhus and hepatic damage
    ZHONG Xiang-mei, WEI Li-jun
    2025, 30(2):  253-257. 
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    Objective To evaluate the efficacy, symptom improvement, and the impact on liver function of doxycycline versus azithromycin in patients with scrub typhus and hepatic impairment, and to analyze the safety of both drugs. Methods A total of 90 patients diagnosed with scrub typhus and hepatic impairment treated from January 2019 to December 2023 at the First People's Hospital of Suqian City were included in the study. Stratified random sampling was used to divide the patients into a trial group (45 patients) and a control group (45 patients). Patients in the control group received azithromycin, while those in the trial group were treated with doxycycline. The two groups were compared in terms of efficacy, symptom improvement, liver function, serum cytokine levels, and adverse reactions. Results The total effective rate of clinical treatment was 95.55% in the experimental group and 91.11% in the control group. Although the experimental group showed slightly better results, the difference was not statistically significant (χ2=0.714, P=0.398). After 7 days of treatment, the experimental group showed significantly shorter durations for fever resolution, headache relief, scab disappearance, reduction of lymph node swelling, rash disappearance, and liver damage recovery, with times of (2.22 ± 1.13) d, (3.22 ± 1.12) d, (3.69 ± 0.47) d, (6.46 ± 1.35) d, (6.23 ± 1.35) d, and (3.75 ± 1.03) d respectively, compared to the control group (4.22 ± 2.13) d, (5.56 ± 2.91) d, (5.82 ± 0.99) d, (9.21 ± 2.94) d, (9.20 ± 2.93) d, and (6.86 ± 1.27) d; all differences were statistically significant (t=5.466, 4.715, 12.283, 5.527, 5.566, 12.184, all P<0.05). Both groups showed a reduction in ALT and AST levels post-trearment, but there was no significant difference between groups (P>0.05). Post-treatment TNF-α, IL-6, and INF-γ levels were significantly lower in the experimental group at (32.59 ± 10.61) ng/L, (52.31 ± 16.31) ng/L, and (1.14 ± 0.52) ng/mL compared to the control group (58.39 ± 11.79) ng/L, (88.57 ± 20.46) ng/L, and (2.48 ± 0.72) ng/mL, respectively (t=10.912, 9.296, 10.561, all P<0.05). The total incidence of adverse reactions such as abdominal pain, diarrhea, nausea, vomiting, headache, somnolence, and dizziness was 4.44% in the experimental group, lower than 15.55% in the control group, although this difference was not statistically significant (χ2=3.086, P=0.079). Conclusion Doxycycline shows rapid improvement in symptoms and decreases in inflammatory markers in patients with scrub typhus and hepatic impairment. Although the overall efficacy is similar to azithromycin, doxycycline shows slight advantages in speeding symptom resolution and safety, making it an effective and safe treatment option.
    MR cholangiopancreatography of congenital choledochal cyst in children and its diagnostic value
    ZHOU Qi-fang, WU Lin, CHEN Meng-meng
    2025, 30(2):  258-261. 
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    Objective To analyze characteristics and diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in children with congenital choledochal cyst (CCC). Methods Between January 2020 and December 2023, 90 children with CCC were admitted to Children's Hospital Affiliated to Soochow University, and 50 children with normal MRI examination were included as the control group. The general MRI data of CCC group and control group were compared, the CCC classification and MRCP manifestations were analyzed, and the performance of conventional MRI, MRCP and DWI examination of CCC was analyzed. Results The largest cross-sectional area of spleen in CCC group was significantly higher than that in control group, and the ratio of length to diameter of gallbladder in CCC group was significantly higher than that in control group. In addition, the diameter of portal vein in CCC group was significantly wider than that in control group, and the differences were statistically significant (P<0.05). MRCP showed that the common bile duct in CCC children was accompanied by cystic, spindle or columnar dilatation in different degrees. Among Todani's classification, type 1 was the most common (70 cases, 77.8%), and Ia was the most common (65 cases, 72.2%). MRCP showed that the cyst was located between the hilum of the liver and the head of the pancreas, with a diameter of 1.4 ~ 7.2 cm, including 23 cases with gallstones (25.5%) and 25 cases with intrahepatic bile duct dilatation (27.8%). No V-type cases were found in each Todani classification. Kurumi typing is mainly C type. In Todani classification, type A and type B were most common, the common channel was 1.3 ~ 2.0 cm, and 6 cases had no abnormal pancreaticobiliary confluence. Conventional MRI combined with MRCP detected 67 cases of CCC (74.4%), and MRI, MRCP combined with DWI diagnosed 83 cases of CCC (92.2%). The diagnostic accuracy of the latter was significantly higher than that of conventional MRI combined with MRCP (P<0.05). Conclusion MRCP plays an important role in the diagnosis of CCC in children, especially in morphological evaluation, complication identification and multi-parameter imaging combined application. Combined with DWI diagnosis mode, the accuracy of imaging examination is further improved, which provides an important reference for clinical diagnosis and treatment of CCC.