Abstract: Objective The purpose of this study was to investigate the diagnostic value of ultrasonic velocity matching and MR diffusion imaging in evaluating liver fibrosis in patients with chronic hepatitis B (CHB). Methods 78 patients with CHB were admitted in our hospital between February 2017 and February 2020, and all received ultrasonic velocity matching check-up for regional velocity index and MR diffusion imaging for apparent diffusion coefficient (ADC) measurement. The liver biopsies were performed in all patients and the liver fibrosis were divided into four stages, e.g. portal area fibrosis for S₁, fibrosis around the portal area for S₂, fibrous septum formation with lobular structure disorder for S₃ and early liver cirrhosis for S₄. The ADC value and regional velocity index were compared in different stages. The diagnostic value of ADC and regional velocity index and their combination in judging liver fibrosis were analyzed by receiver operating characteristic curve (ROC). Results There were 20 cases of S₁ stage, 18 cases of S₂ stage, 24 cases of S₃ stage and 16 cases of S₄ stages in our 78 patients after histopathological examination; the regional velocity index in patients with S₁ was (21.7±5.9) m/s, which was significantly lower than 【(26.8±7.3) m/s, P<0.05】 in patients with S₂, or 【(33.5±8.1) m/s, P<0.05】 in patients with S₃ or 【(36.0±9.2) m/s, P<0.05】 in those with S₄; there were significant differences in regional velocity index among four groups of different stages of liver fibrosis(P<0.05); the ADC value in patients with S₁ was (1.3±0.2)× 10^-3mm²/s, which was significantly higher than 【(1.2±0.2)×10^-3mm²/s, P<0.05】 in patients with S₂, or 【(1.1±0.1)×10^-3mm²/s, P<0.05)】 in patients with S₃ or 【(0.9±0.1)×10^-3mm²/s, P<0.05】 in patients with S₄; there were significant difference in ADC among the four groups of different stages of liver fibrosis (P<0.05); the ROC analysis showed that the area under the curve (AUC)of regional velocity index in judging >S₂ stage of liver fibrosis was 0.724 (95%CI=0.597-0.851),with the sensitivity and specificity of 0.750 and 0.532, respectively, and the AUC of ADC in judging >S₂ stage of liver fibrosis was 0.715 (95%CI=0.569-0.861), with the sensitivity of 0.758 and the specificity of 0.625, whereas the AUC of the two combination in judging >S₂ stage of liver fibrosis was 0.809 (95%CI=0.678-0.910), with the sensitivity of 0.813 and the specificity of 0.710; the AUC of the combination of the two parameters in judging >S₂ stage of liver fibrosis in patients with chronic hepatitis B was significantly higher than those by any of the two examination alone (P<0.05). Conclusion It is practical to evaluate the liver fibrosis staging or the early screening of liver cirrhosis by ultrasonic velocity matching and MR diffusion imaging, and the dynamic monitoring of liver fibrosis by the regional velocity index and ADC value even helpful.

Key words: Hepatitis B, Ultrasonography, Ultrasonic velocity matching, MR diffusion imaging, Diagnosis