脂肪肝的磁共振检测与对照分析  

MRI diagnosis and control assessment of fatty liver

作　　者：钟喨[1] 陈洁[1] 程杰军[1] 王文晶[1] 李磊[1] 姚秋英[1] 李岚[1] 路青[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200001

出　　处：《中国医学影像技术》2008年第12期1984-1987,共4页Chinese Journal of Medical Imaging Technology

基　　金：上海交通大学科技基金(05XJ21104)

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MRT1WIIP/OP序列、T2WITSE/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。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.

关 键 词：脂肪肝 体层摄影术 X线计算机 磁共振成像 

分 类 号：R575.5[医药卫生—消化系统] R814.42[医药卫生—内科学]