張羲娥 1,2 , 劉曦嬌 1 , 黃子星 1 , 袁放 1 , 宋彬 1 , 張威 1
  • 1.四川大學(xué)華西醫(yī)院放射科(四川成都 610041);;
  • 2.成都市第二人民醫(yī)院放射科(四川成都 610017);

目的探討在3.0 T MRI中運(yùn)用氫質(zhì)子波譜成像(1H-MRS)技術(shù)評(píng)估脂肪肝治療效果的可行性。方法收集臨床確診并治療的脂肪肝患者26例，分別于治療前、治療后3和6個(gè)月各行1次 1H-MRS檢查，測(cè)得 1H-MRS的水峰峰值和脂肪峰峰值、水峰峰下面積和脂肪峰峰下面積，計(jì)算肝細(xì)胞相對(duì)脂肪含量1(RLC1)及相對(duì)脂肪含量2(RLC2); 同期測(cè)量患者的甘油三酯、γ-谷氨酰轉(zhuǎn)肽酶、腹圍及體重指數(shù)，將其擬合成臨床脂肪肝指數(shù)(fatty liver index，F(xiàn)LI)。以FLI為參照標(biāo)準(zhǔn)，對(duì)不同時(shí)間點(diǎn) 1H-MRS所測(cè)得肝臟脂肪含量進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果采用配伍設(shè)計(jì)的方差分析，治療前、治療后3和6個(gè)月的RLC1、RLC2值比較差異有統(tǒng)計(jì)學(xué)意義(P lt;0.05); 用SNK法做兩兩檢驗(yàn)，治療前RLC1、RLC2值均分別明顯高于治療后3個(gè)月或治療后6個(gè)月的RLC1、RLC2值(P lt;0.05)。RLC1、RLC2與FLI進(jìn)行秩相關(guān)性分析，均呈正相關(guān)性(r=0.476，P lt;0.001; r=0.475，P lt;0.001)?？煽啃苑治鲲@示，治療前的組內(nèi)相關(guān)系數(shù)均≥0.75，可重復(fù)性好。結(jié)論1H-MRS定量分析評(píng)估脂肪肝治療效果具有可行性，并且是一種無(wú)創(chuàng)的定量監(jiān)測(cè)方法。

引用本文： 張羲娥,劉曦嬌,黃子星,袁放,宋彬,張威. 3.0 T 1H-MRS定量分析評(píng)估脂肪肝治療效果的初步研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(12): 1330-1333. doi: 復(fù)制

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18. Rinella ME, McCarthy R, Thakrar K, et al. Dualecho, chemical shift gradientecho magnetic resonance imaging to quantify hepatic steatosis: Implications for living liver donation [J]. Liver Transpl, 2003, 9(8): 851856.
19. Cassidy FH, Yokoo T, Aganovic L, et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis [J]. Radiographics, 2009, 29(1): 231260.
20. FriedrichRust M, Müller C, Winckler A, et al. Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MRspectroscopy, and serum markers [J]. J Clin Gastroenterol, 2010, 44(1): 5865.
21. Machann J, Thamer C, Schnoedt B, et al. Hepatic lipid accumulation in healthy subjects: a comparative study using spectral fatselective MRI and volumelocalized 1HMR spectroscopy [J]. Magn Reson Med, 2006, 55(4): 913917.
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23. Kim H, Taksali SE, Dufour S, et al. Comparative MR study of hepatic fat quantification using singlevoxel proton spectroscopy, twopoint dixon and threepoint IDEAL [J]. Magn Reson Med, 2008, 59(3): 521527.
24. Ricci PE, Pitt A, Keller PJ, et al. Effect of voxel position on singlevoxel MR spectroscopy findings [J]. AJNR Am J Neuroradiol, 2000, 21(2): 367374.
  1. 1. Bedogni G, Bellentani S, Miglioli L, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population [J]. BMC Gastroenterol, 2006, 6: 3339.
  2. 2. 范建高, 李新建, 朱軍, 等. 上海市成人代謝綜合征與脂肪肝關(guān)系分析 [J]. 中華內(nèi)分泌代謝雜志, 2005, 21（4）: 306309.
  3. 3. 向國(guó)卿, 孟憲云, 張浩, 等. 脂肪肝相關(guān)危險(xiǎn)因素的評(píng)估 [J]. 世界華人消化雜志, 2009, 17（10）: 10381041.
  4. 4. Hourigan KJ, Bowling FG. Alcoholic liver disease: a clinical series in an Australian private practice [J]. J Gastroenterol Hepatol, 2001, 16(10): 11381143.
  5. 5. NeuschwanderTetri BA. Fatty liver and nonalcoholic steatohepatitis [J]. Clin Cornerstone, 2001, 3(6): 4757.
  6. 6. Angulo P. GI epidemiology: nonalcoholic fatty liver disease [J]. Aliment Pharmacol Ther, 2007, 25(8): 883889.
  7. 7. 倪燕君, 劉厚鈺, 胡德昌, 等. 脂肪肝臨床病理分析 [J]. 中華消化雜志, 2001, 21（2）: 98101.
  8. 8. Diehl AM. Nonalcoholic steatohepatitis [J]. Semin Liver Dis, 1999, 19(2): 221229.
  9. 9. Targher G, Arcaro G. Nonalcoholic fatty liver disease and increased risk of cardiovascular disease [J]. Atherosclerosis, 2007, 191(2): 235240.
  10. 10. Graif M, Yanuka M, Baraz M, et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease [J]. Invest Radiol, 2000, 35(5): 319324.
  11. 11. 李文政, 彭光春, 湯恢煥, 等. 脂肪肝CT、MRI定量診斷的對(duì)照實(shí)驗(yàn)研究 [J]. 醫(yī)學(xué)影像學(xué)雜志, 2005, 15（4）: 294297.
  12. 12. 盛明洪, 呂斌, 周興祥, 等. 二維超聲圖像定量診斷脂肪肝病變程度的應(yīng)用研究 [J]. 臨床超聲醫(yī)學(xué)雜志, 2005, 7（1）: 1820.
  13. 13. Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver [J]. AJR Am J Roentgenol, 2007, 188(5): 13071312.
  14. 14. 劉云霞, 王潔貞, 劉建平, 等. 脂肪肝影像學(xué)診斷性試驗(yàn)的系統(tǒng)評(píng)價(jià) [J]. 中國(guó)醫(yī)學(xué)科學(xué)院學(xué)報(bào), 2004, 26（5）: 580584.
  15. 15. 許驊, 王嵩, 耿道穎, 等. CT定量分析脂肪肝的臨床應(yīng)用初探 [J]. 中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志, 2004, 10（4）: 250253.
  16. 16. Sanyal AJ; American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease [J]. Gastroenterology, 2002, 123(5): 17051725.
  17. 17. Borra RJ, Salo S, Dean K, et al. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with inphase and outofphase Mr imaging [J]. Radiology, 2009, 250(1): 130136.
  18. 18. Rinella ME, McCarthy R, Thakrar K, et al. Dualecho, chemical shift gradientecho magnetic resonance imaging to quantify hepatic steatosis: Implications for living liver donation [J]. Liver Transpl, 2003, 9(8): 851856.
  19. 19. Cassidy FH, Yokoo T, Aganovic L, et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis [J]. Radiographics, 2009, 29(1): 231260.
  20. 20. FriedrichRust M, Müller C, Winckler A, et al. Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MRspectroscopy, and serum markers [J]. J Clin Gastroenterol, 2010, 44(1): 5865.
  21. 21. Machann J, Thamer C, Schnoedt B, et al. Hepatic lipid accumulation in healthy subjects: a comparative study using spectral fatselective MRI and volumelocalized 1HMR spectroscopy [J]. Magn Reson Med, 2006, 55(4): 913917.
  22. 22. 趙黎明, 宋彬, 陳光文, 等. 肝臟脂肪含量MRI定量診斷與病理對(duì)照研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18（6）: 666671.
  23. 23. Kim H, Taksali SE, Dufour S, et al. Comparative MR study of hepatic fat quantification using singlevoxel proton spectroscopy, twopoint dixon and threepoint IDEAL [J]. Magn Reson Med, 2008, 59(3): 521527.
  24. 24. Ricci PE, Pitt A, Keller PJ, et al. Effect of voxel position on singlevoxel MR spectroscopy findings [J]. AJNR Am J Neuroradiol, 2000, 21(2): 367374.