钟喨,陈洁,程杰军,王文晶,李磊,姚秋英,李岚,路青.脂肪肝的磁共振检测与对照分析[J].中国医学影像技术,2008,24(12):1984~1987
脂肪肝的磁共振检测与对照分析
MRI diagnosis and control assessment of fatty liver
投稿时间:2008-04-29  修订日期:2008-10-09
DOI:
中文关键词:  脂肪肝  体层摄影术,X线计算机  磁共振成像
英文关键词:Fatty liver  Tomography, X-ray computed  Magnetic resonance imaging
基金项目:上海交通大学科技基金(05XJ21104)。
作者单位E-mail
钟喨 上海交通大学医学院附属仁济医院放射科,上海 200001 zhong-liang@online.sh.cn 
陈洁 上海交通大学医学院附属仁济医院放射科,上海 200001  
程杰军 上海交通大学医学院附属仁济医院放射科,上海 200001  
王文晶 上海交通大学医学院附属仁济医院放射科,上海 200001  
李磊 上海交通大学医学院附属仁济医院放射科,上海 200001  
姚秋英 上海交通大学医学院附属仁济医院放射科,上海 200001  
李岚 上海交通大学医学院附属仁济医院放射科,上海 200001  
路青 上海交通大学医学院附属仁济医院放射科,上海 200001  
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中文摘要:
       目的 评价磁共振成像和氢质子波谱分析对脂肪肝定量检测的影像技术和临床应用。方法 收集弥漫性脂肪肝病例27例,同期进行体重指数(BMI)测量、血清总胆固醇(TCH)、甘油三脂(TG)、丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)化验以及CT、MR检查和氢质子波谱分析(1H-MRS)。CT平扫计算肝/脾CT密度比值(L/S)。MR检查包括T1WI快速梯度回波(TFE)序列同相位(IP)和反相位(OP)双扫描,T2WI采用快速自旋回波(TSE)序列和谱线衰减翻转恢复序列(SPAIR)脂肪抑制技术。应用图像分析软件MRIcro测定T1WI、T2WI各图像上的MR信号值,分别计算肝脏脂肪含量。1H-MRS应用单体素PRESS序列,采用jMRUI软件包测定水峰和脂质峰峰值,计算肝细胞内脂肪含量。结果 MR T1WI IP/OP序列、T2WI TSE/SPAIR序列和1H-MRS测定的肝脏脂肪含量与CT测定的L/S比值均呈显著性负相关,r值分别为-0.85(P<0.0001)、-0.71(P<0.0001)和-0.47(P=0.014)。血清ALT与CT、MR检查和1H-MRS测定的肝脏脂肪含量之间均有显著相关性。结论 MRI和氢质子波谱分析是脂肪肝定量诊断的有效检测方法;1H-MRS能够更精确地反映脂肪肝的严重程度。
英文摘要:
      Objective To evaluate the imaging technologies and clinical application of quantitative diagnosis of fatty liver with MRI and 1H-MR spectroscopy (1H-MRS). Methods Twenty-seven patients with diffused fatty liver underwent CT scan, MR imaging and proton spectroscopy. Body mass index (BMI), the blood lipid and liver function were tested within the corresponding period, including serum total cholesterol (TCH), triglyceride (TG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). CT attenuation ratio of liver to spleen (L/S) was calculated in plain CT scan. MR T1WI included dual-echo turbo field echo (TFE) sequence with inphase (IP) and outphase (OP) images. T2WI was acquired using turbo spin echo (TSE) sequence. T2WI fat-suppression technique used spectral attenuated inversion recovery sequence (SPAIR). Liver fat was quantified as the percentage of relative signal intensity loss on T1WI or T2WI images using MRIcro image analysis software. 1H-MRS was performed using point resolved selective spectroscopy (PRESS) sequence, and the liver fat content was expressed as percentage ratio of liquid to water peaks which were measured by jMRUI software package. Results Liver fat contents calculated on MR T1WI IP/OP, T2WI TSE/SPAIR images and 1H-MRS had significant relationship with CT L/S ratio (r=-0.85, P<0.0001; r=-0.71, P<0.0001; r=-0.47, P=0.014, respectively). Serum ALT also significantly correlated with CT L/S ratio and the liver fat percentages measured on T1WI IP/OP, T2WI TSE/SPAIR sequence and 1H-MRS, respectively. Conclusion MRI and 1H-MRS are effective methods for quantitative detecting of fatty liver. 1H-MRS can accurately reflect the severity of fatty liver.
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