氢质子磁共振波谱成像在肝纤维化分期诊断中的意义研究  

To Investigate the Significance of Hydrogen Magnetic Resonance Spectroscopy imaging in Diagnosis of Hepatic Fibrosis Staging

作　　者：李晓栋[1] 娄江华[1] 李攀[1] 孙明华[1] 刘红明[1] 李海婷[1] 

机构地区：[1]河南省人民医院放射科,郑州450003

出　　处：《中国继续医学教育》2015年第23期64-66,共3页China Continuing Medical Education

摘　　要：目的研究氢质子磁共振波谱(1 H-MRS)中脂质(Lip)和胆碱(Cho)峰值及峰下面积数据在肝脏纤维化分期的应用。方法收集经组织学证实的肝纤维化患者55例,对其进行1H-MRS成像,并计算脂质(Lip)和胆碱(Cho)峰值及峰下面积共4个参数(Lip-Amp、Lip-Are、Cho-Amp、Cho-Are),分析其与肝纤维化分期之间的相关性。结果 55例患者中,S 0期16例,S 1期12例,S 2期11例,S 3期8例,S 4期8例,其脂质和胆碱峰值及峰下面积与其分期呈正相关。根据ROC曲线分析,单一参数对于患者肝纤维化分期的灵敏度及特异性较低,而4个参数联合区分肝纤维化相邻两区的ROC曲线下面积分别为0.875、0.848、0.830、0.813,具有较高的应用价值。结论脂质和胆碱峰值及峰下面积联合诊断患者肝纤维化分期的效果要优于单一指标。Objective To investigate the application of peak value of lipid （ Lip ） and choline （ Cho ） in hydrogen proton magnetic resonance spectroscopy （1H-MRS ） as well as its area under the peak in the diagnosis of hepatic ifbrosis staging.Methods Selected 55 hepatic ifbrosis patients who were diagnosed by histology, and then the1 H-MRS imaging was performed on them. Parameters as the peak value and the area under the peak of lip and cho of every patient （ Lip-Amp, Lip-Are, Cho-Amp and Cho-Are） were calculated. Analyze their correlation with the hepatic fibrosis staging. Results Among all the 55 patients, there were 16 cases in stage 0, 12 in stage 1, 11 in stage 2, 8 in stage 3 and the same for stage 4, and their peak value as well as the area under the peak of lip and cho had a positive correlation with their staging. According to the ROC curve, it can be observed that single parameter had relatively low sensitivity and speciifcity in diagnosis of hepatic ifbrosis staging while the effect got better when diagnosing with 4 combined parameters and the sensitivity and speciifcity of combined diagnosis were 0.875, 0.848, 0.830, 0.813, it had good application value.Conclusion The effect of combined diagnosis with peak value and the area under the peak of lip and cho has better than that of the single diagnosis.

关 键 词：磁共振波谱 肝纤维化分期 脂质 胆碱 ROC曲线 

分 类 号：R811.2[医药卫生—放射医学]