~1H-MRS在慢性血吸虫肝病诊断中的价值  

The Value of Proton Magnetic Resonance Spectroscopy in Diagnosis of Chronic Hepatic Schistosomiasis

作　　者：张洪[1] 胡明秀[2] 李长富[2] 王国光 孔鹏[2] 孟令平[2] 

机构地区：[1]泰山医学院,泰安271000 [2]上海市第六人民医院金山分院放射科,201599

出　　处：《临床放射学杂志》2017年第11期1652-1656,共5页Journal of Clinical Radiology

基　　金：上海市卫生计生委课题面上项目(编号:201540242)

摘　　要：目的探讨~1H-MRS在慢性血吸虫肝病中的诊断价值。方法分别对经临床及病理证实的慢性血吸虫肝病患者30例(肝病组)和健康志愿者38名(对照组)行肝脏常规MRI和~1H-MRS检查,测量相关代谢物[水(H_2O)、胆碱(Cho)、脂质(Lip)]的峰值及峰下面积,并进行统计分析。结果慢性血吸虫肝病组和对照组MRS图像主要显示为H_2O峰(4.6 ppm)、Cho峰(3.2 ppm)和Lip峰(1.3 ppm);慢性血吸虫肝病组~1H-MRS H_2O峰、Lip峰峰值及峰下面积均低于对照组,且有统计学意义(P<0.05);Cho峰峰值及峰下面积与对照组差异无统计学意义(P>0.05)。受试者工作特征曲线(ROC)曲线下面积(AUC)从大到小依次为H_2O峰值、H_2O下面积、Lip峰下面积、Lip峰值,其AUC分别为0.805、0.761、0.729、0.668,特异度分别为0.600、0.733、0.670、0.633,敏感度分别为0.921、0.737、0.789、0.737;联合得到MRS的AUC是0.861、特异度0.684、敏感度0.867。结论 ~1H-MRS对慢性血吸虫肝病诊断有一定价值,其中H_2O峰值及峰下面积诊断效能最高。Objective To investigate the value of proton magnetic resonance spectroscopy（^1H-MRS） in the diagnosis of chronic hepatic schistosomiasis. Methods 30 subjects with chronic hepatic schistosomiasis that was confirmed clinically and by pathology and 38 subjects without liver disease underwent conventional MRI and ^1H-MRS of liver. The peak heightand peak area of metabolites（ water,cho,lipid） were measured and statistically analyzed. Results The groups of chronic hepatic schistosomiasis and no liver disease MRS image mainly displayed as H2O peak（4. 6 ppm）,Cho peak（3. 2 ppm）and Lipid peak（1. 3 ppm）;Chronic hepatic schistosomiasis were lower than the control group in the peak height and peak area of water and lipid（ P〈0. 05）; the peak height and peak area of Cho was not statistically significant（ P〉0. 05）. Under ROC curve AUC of values of water peak,area under water peak,area under lipid peak,the values of lipid peak were analysed. The AUC were 0. 805,0. 761,0. 729,0. 668,respectively;the specificity of these parameters were 0. 600,0. 733,0. 670,0. 633 and the sensitivity were 0. 921,0. 737,0. 789,0. 737,respectively. MRS area under the ROC curve was0. 861,specificity 0. 684 and sensitivity 0. 867. Conclusion^1H-MRS diagnosis of chronic schistosomiasis liver disease has a certain value. The values of water peak and area under water peak are efficient in making the diagnosis.

关 键 词：血吸虫性 肝疾病 磁共振成像 磁共振^1H波谱 ROC曲线 

分 类 号：R445.2[医药卫生—影像医学与核医学] R532.21[医药卫生—诊断学]