T2^＊校正的多回波Dixon技术定量分析非酒精性脂肪肝的临床应用研究  

Quantitative analysis of the degree of nonalcoholic fatty liver disease with T_2~*-corrected multi-echo Dixon technique of MRI

作　　者：马静[1] 宋志强[1] 宋琼[2] 严福华[3] 方佳[1] 宋发亮[1] 

机构地区：[1]石河子大学医学院第二附属医院(兵团医院)影像中心,乌鲁木齐830000 [2]浙江省人民医院放射科,杭州310034 [3]上海瑞金医院放射科,上海200025

出　　处：《放射学实践》2014年第4期423-427,共5页Radiologic Practice

摘　　要：目的：探讨T2^＊校正的多回波Dixon技术定量测量非酒精性脂肪肝患者肝细胞脂肪变性的临床应用价值。方法：将27例经临床诊断为非酒精性脂肪肝并自愿接受肝穿刺活检的患者（实验组）及10例健康志愿者（对照组）纳入研究。对所有研究对象均采用双回波和T2^＊校正的多回波Dixon序列行肝脏MRI扫描，测量肝脏的脂肪分数（FF双回波和FF多回波）。实验组患者在MRI检查1天后行肝脏穿刺活检，进行病理学观察并测量脂肪百分比（LCR），并相应的将患者脂肪变性程度分为正常（〈5％）、轻度（5％～33％）、中度（〉33％且〈66％）和重度（≥66％）共4级。对MRI测量的脂肪分数与病理测量的脂肪百分比间的关系采用Spearman相关分析。对照组与实验组间脂肪分数（FF）的比较采用f检验，实验组中不同脂肪变性程度间脂肪分数的比较采用方差分析，并进行ROC曲线分析。结果：双回波和多回波序列测量的FF值在实验组和对照组间差异均有高度统计学意义（t双回波=-8．055，P〈0．001；t多回波=-7．933，P〈0．001）。以病理学检查为金标准，FF双回波和FF多回波与脂肪百分比（LCR）呈正相关关系（r双回波=-0．789，P〈0．001；r多回波=-0．862，P〈0．001）。不同脂肪变性程度分级之间FF的差异有高度统计学意义（F双回波=-81．096，P〈0．001；F多回波=141．749，P〈0．001），但多回波技术获得的FF多回波在轻度与中度、轻度与重度和中度与重度之间差异均有统计学意义。ROC曲线分析显示，T2^＊校正多回波Dixon技术测量的FF多回波的诊断效能较好。结论：T2^＊校正的多回波Dixon技术是一种便捷、准确的定量分析肝脏脂肪变性的影像学方法，值得在临床广泛应用。Objective.. To evaluate the clinical application value of T2 ＊ -corrected multi-echo Dixon technique for quantification study on hepatocyte steatosis in nonalcoholic fatty liver disease （NAFLD）. Methods.. 27 NAFLD patients diagnosed clinically and 10 healthy volunteers accepted MRI examination with dual-echo and T2 ＊ -corrected multi-echo Dixon sequence on 3.0T MR scanner. All the patients accepted liver biopsy and pathological examination just one day after MRI examination. The percentage of steatotic hepatocyte （PSH） was measured, and then the degree of fatty degeneration were divided into four levels ： normal, mild, medium and severe, with PSH〈 5 %, 5 %- 33 %, 〉 33% and 〈66%, and ≥ 66% respectively. The fat fractions （FFdoal ocho and FFmulti-echo） Of liver in patient group and volunteer group, obtained by T2 ＊-corrected dualecho and multi-echo Dixon sequences,were compared with t-test. The relationship between FF and pathological results was analyzed by Spearman correlation analysis. In patient group, the FFs in four groups with different degree of hepatic steatosis were compared with ANOVA method,and the ROC curve of FF was also studied. Results.. Both FFs in patient group mea- sured on T2 ＊ -corrected dual-echo and multi-echo Dixon sequences were higher than that in volunteer group, with significant statistical difference（tdual-eoho=- 8. 055, P〈0. 00 ; tmuli-echo = - 7. 933, P〈0. 001 ）. There was positive correlation between FFs and degree of fatty degeneration （rdual-echo = 0. 789, P〈0. 001 ; rmuli-echo= 0. 862, P〈 0. 001 ）. The FFs in mild, moderate and severe steatosis group were not statiscally different （Fdual-echo = 81. 096 ,P〈0. 001 ; Fmuli-echo = 141. 749 ,P〈0. 001）. With pathological results as the golden standard,ROC curve analysis showed that the diagnostic efficiency of FFmuli-echo was better than that of FFdual-echo. Conclusion： T2 ＊ -corrected multi-echo Dixon technique is a convenient and accurate method for quantitative detection of l

关 键 词：磁共振成像 多回波技术 脂肪肝 非酒精性 脂肪分数 

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