血生化、超声、CT、^1H MRS定量诊断脂肪肝的综合对照实验研究  

A comparative experimental study of quantitative diagnosis of fatty liver by biochemistry, ultrasonography, CT and ^1H MRS

作　　者：苏中振[1] 单鸿[1] 何炳钧[1] 吕文天[1] 孟晓春[1] 王劲[1] 朱康顺[1] 杨扬 陈规划 

机构地区：[1]中山大学附属第三医院放射科 [2]肝移植科,广东广州510630

出　　处：《中国医学影像技术》2008年第7期977-980,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省自然科学基金(06021217)

摘　　要：目的比较生化、超声、CT、1H MRS检查在脂肪肝诊断中的临床价值。方法选用45只健康新西兰大白兔,采用高脂高糖饲料加酒精饮料建立不同程度脂肪肝模型,应用生化、超声、CT及1H MRS多种临床诊断手段,观测多个变量指标,并进行对照研究。组间差异采用单因素方差分析和LSD检验,相关性采用等级相关分析。结果在所选择的18个观测指标中,血清谷草转氨酶、胆固醇、甘油三脂、超声衰减系数、肝CT值、肝/竖脊肌密度比率、1H MRS脂肪峰值、脂肪波峰下面积、脂/水波峰下面积比率、脂肪百分比等10个指标存在组间差异性,且与脂肪肝分级具有显著性相关,其中血清胆固醇、超声衰减系数、肝CT值和1H MRS脂肪曲线下面积分别是生化、超声、CT、MRS诊断方法中与脂肪肝分级相关系数最高的观测指标,相关系数分别为0.886、0.483、-0.764、0.558。结论在脂肪肝的临床诊断中,生化、CT检查的应用价值高于超声波和1HMRS检查。Ojective To compare the values of biochemistry, ultrasonography, CT and ^ 1H MRS in the quantitative diagnosis of fatty liver. Methods Forty-five healthy New Zealand rabbits were randomly divided into one normal control and three experimental groups. Hepatic steatosis models were established by giving high fat, high sugar diet with drinking water containing five percent ethanol. Eighteen variable indexes were measured by biochemical examination, ultrasonography, CT, 1 H MRS. Univariate analysis, LSD test, and correlation analysis were used. Results By statistical analysis, there were ten variable indexes with significant differences among the groups and correlated with hepatic steatosis grade, which were serum AST, TC, TG, ultrasound attenuation coefficient, liver CT value, liver-muscle density ratio, ^ 1H MRS fat peak value, fat peak area, fat-water peak area ratio, fat percentage. Among them serum TC, ultrasound attenuation coefficient, liver CT value and^ 1 H MRS fat peak area had the highest degree of relationship with hepatic steatosis grade. The correlation coefficients of biochemical examination, ultrasonography, CT,^ 1H MRS in diagnosis of fatty liver were 0. 886, 0. 483, -0. 764, 0. 558, respectively. Conclusion The values of biochemical examination and CT in the quantitative diagnosis of fatty liver are higher than ultrasonography and ^1 H MRS.

关 键 词：兔 诊断 脂肪肝 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]