T2校正^1H-MRS定量分析慢性丙型肝炎肝脂肪变程度的研究  

Quantitative Assessment of Hepatic Fat Content in Chronic Hepatitis C Using T2 Corrected 1H-MR Spectroscopy

作　　者：石喻[1] 夏菲[2] 张兰[1] 卞胜昕[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004 [2]中国医科大学附属盛京医院感染科,辽宁沈阳110004

出　　处：《中国医学影像学杂志》2013年第1期36-39,共4页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金项目(81071123)

摘　　要：目的探讨T2校正1H-MRS定量分析慢性丙型肝炎患者肝脂肪含量(HFC)的可行性。资料与方法应用3.0T1H-MRS定量测量43例慢性丙型肝炎患者的HFC,评价HFC与组织学结果及代谢物指标的相关性,分析不同丙型肝炎基因型之间HFC的差异。结果 1H-MRS测量的丙型肝炎的HFC范围为1%～29%,与病理分级呈正相关(r=0.71,P<0.01);HFC与稳态模型胰岛素抵抗指数(r=0.43,P<0.05)、稳态模型β细胞功能(r=0.42,P<0.05)、体重指数(r=0.41,P<0.05)、丙氨酸氨基转移酶(r=0.38,P<0.05)和天冬氨酸氨基转移酶(r=0.56,P<0.05)均呈正相关;HFC与肝纤维化程度无相关性(r=-0.03,P>0.05)。患者基因型包含1b型23例,2a型14例,混合型6例,不同丙型肝炎基因型之间HFC差异无统计学意义(χ2=0.37,P>0.05)。结论 1H-MRS可准确定量分析慢性丙型肝炎患者的HFC,适合临床工作。Purpose To quantity hepatic fat content （HFC） using T2 corrected 1H- MR spectroscopy （1H-MRS） in patients with chronic hepatitis C （HCV）. Materials and Methods Forty-three patients with chronic HCV were assessed by 1H-MRS at 3.0T. Correlations were evaluated among histological grading, metabolic indexes and HFC. The HFC differences among different HCV genotypes were also assessed. Results HFC range assessed by 1H-MRS was 1%-29%, and HFC were positively correlated with pathologic steatosis stages （r=0.71, P〈0.01） . HFC was also moderately correlated with HOMA- IR （r-0.43, P〈0.05）, HOMA-β （r=0.42, P〈0.05）, BMI （r=0.41, P〈0,05）, ALT （r=0.38, P〈0.05） and AST r=0.56, P〈0.05）. HFC was not correlated with liver fibrosis （r=-0.03, P〉0.05）. In 43 patients, 23 were genotype lb, 14 were genotype 2a, and 6 were mixed type, which showed no difference in HFC measured by 1H-MRS （X2=0.37, P〉0.05）. Conclusion 1H-MRS is a promising method in detecting liver steatosis in HCV patients, and it is suitable for clinical application.

关 键 词：肝炎 丙型 慢性 脂肪肝 磁共振成像 磁共振波谱学 

分 类 号：R512.63[医药卫生—内科学] R445.2[医药卫生—临床医学]