Gd-DTPA增强对于肝脏及肝脏疾病31P-MRS代谢参数的影响  

Influence of Gd--DTPA Enhancement on Metabolism of Liver and Hepatic Diseases using In Vivo 31- Phosphorus Magnetic Resonance Spectroscopy at 3.0 Tesla

作　　者：于德新[1] 马祥兴[1] 李笃民[1] 张晓明[1] 张凯[1] 李传福[1] 

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012

出　　处：《实用放射学杂志》2010年第9期1286-1289,共4页Journal of Practical Radiology

摘　　要：目的 探讨Gd-DTPA增强对于肝脏及肝脏疾病31P-MRS代谢参数的影响.方法 分别对肝内良、恶性病变（分别为31例和54例）及肝硬化和正常肝脏（分别为34例和21例）进行单体素31P-MRS扫描.计算肝细胞内pH值（pHi）、磷酸单脂（PME）、磷酸双脂（PDE）、无机磷（Pi）、γ-ATP、β-ATP、α-ATP、PME/ATP、Pi/ATP、PME/PDE、PME/Pi、PDE/Pi、PDE/ATP和低能磷酸盐（LEP）等参数.分析Gd-DTPA增强前、后肝内病变的显示情况,以及以上代谢物参数的差异.结果 Gd-DTPA增强前在体线圈定位图像上,肝癌、转移瘤和胆管癌显示欠佳或其边界欠清者分别占该病总数的47.8%（11/23）、13.6%（3/22）和66.7%（6/9） 增强后则分别为13.0%（3/23）、4.5%（1/22）和22.2%（2/9） 增强前肝脓肿、海绵状血管瘤、局灶性结节增生及腺瘤显示欠佳或其边界欠清的分别占该病总数的11.1%（1/9）、29.4%（5/17）、80%（4/5）,增强后分别为0%（0/9）、5.9%（1/17）、0%（0/5）.在增强前和增强后,正常肝脏,肝硬化,肝脏良、恶性病变的31P-MRS各代谢物参数均未见统计学差异（P〉0.05）.结论 Gd-DTPA增强技术可增加31P-MRS定位的准确性,钆对比剂不影响肝脏及其疾病代谢物检测的准确性.Objective To probe the influence of Gd--DTPA enhancement on metabolism of liver and hepatic diseases using in vivo 31 - phosphorus magnetic resonance spectroscopy（31 P- MRS）. Methods 31 P- MRS scanning of liver with a single voxel was carried out in 31 cases with benign lesions,54 cases with malignant ones,34 cases with liver cirrhosis and 21 healthy subjects,respectively. Intracellular pH value （ pHi）, and some metabolic parameters including phosphomonoester （ PME ）, phosphodiester （ PDE）, inorganic phosphate（Pi）, α- ATP, β- ATP, γ- ATP, lower energetic phosphate（ LEP）, and the ratios of PME/ATP, Pi/ATP, PME/PDE, PME/Pi,PDE/Pi and PDE/ATP were calculated . The differences in display of the lesions , and in the metabolic parameters above were analyzed. Results Before the contrast--enhancement,hepatocellular carcinoma, metastasis and hepatic cholangiocarcinoma with unclear display or with undefinitive margin on position images were showed in 11,3 and 6, while those were 3,1 and 2 after enhancement. Before enhancement, the abcess, heamangioma, and FNH plus adenoma were showed in 1,5 and 4, while after enhancement those were 0,1 and 0 respectively. The metabolic parameters of liver in normal liver,cirrhosis, benign and malignant lesions of liver were not of difference statistically（P〉0.05）befor and after enhancement. Conclusion Gd--DTPA enhancement may improve the accuracy of 31 P- MRS position image,and the contrast agents do not influence on the detection accuracy of metabolic parameters of liver.

关 键 词：肝脏 对比剂增强 磁共振波谱 

分 类 号：R575[医药卫生—消化系统] R445.2[医药卫生—内科学]