应用MR mDixon-Quant技术测量乳腺癌患者内分泌治疗后肝脏脂肪含量及临床分析  

Liver Fat Content and Clinical Analysis of Fatty Liver in Breast Cancer Patients After Endocrine Therapy Using mDixon-Quant Imaging at MR

作　　者：周享媛 曾乔 王烈亮[1] 贺方书[1] 周锋江[1] 刘岚[1] ZHOU Xiangyuan;ZENG Qiao;WANG Lieliang(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,南昌大学附属肿瘤医院,330029

出　　处：《实用癌症杂志》2021年第9期1467-1471,共5页The Practical Journal of Cancer

基　　金：江西省卫生计生委科技计划(编号:20185362)。

摘　　要：目的应用MR mDixon-Quant技术精确测量乳腺癌患者内分泌治疗后肝脏脂肪含量,分析患者脂肪肝发生的临床特点,为临床动态监测乳腺癌内分泌治疗后脂肪肝的发生、尽早给予干预治疗提供重要参考。方法收集73例手术后病理显示激素受体阳性、内分泌治疗至少两年的乳腺癌患者,治疗前后均行肝脏3.0T MR mDixon-Quant检查,精确测量肝脏的脂肪含量并按照外文标准以肝脏MR质子密度脂肪分数(proton-density fat fraction,PDFF)大于6.4%作为脂肪肝的诊断标准,用于判断患者有无脂肪肝的发生。并根据标准把脂肪肝分成轻度、中度、重度。另于磁共振检查当天抽取空腹静脉血标本进行肝功能检查。将磁共振PDFF值与肝功能主要指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)进行对比分析。结果73例乳腺癌术后内分泌治疗后2年中共有27例发生脂肪肝,发生率为36.9%(27/73),PDFF为(15.25±6.42)%;发生脂肪肝最早的时间在内分泌治疗后3个月;27例脂肪肝以轻、中度脂肪肝为主,占81.5%(22/27),轻度、中度、重度脂肪肝PDFF分别为(8.76±2.21)%、(18.65±1.23)%、(24.00±1.12)%。患者脂肪肝发生前后和不同程度脂肪肝组ALT、AST差异有统计学意义(P<0.05)。27例脂肪肝患者PDFF均提示肝脏脂肪含量增加,但其中仅19例肝功能ALT、AST指标异常,另8例尚处于正常范围。结论应用MR mDixon-Quant技术可精确测量乳腺癌内分泌治疗后脂肪肝患者肝脏脂肪含量、判断脂肪肝的程度,要比肝功能指标ALT、AST更早提示肝脏脂肪沉积及受损情况,可为临床动态监测乳腺癌内分泌治疗后脂肪肝的发生并给予及早的干预治疗提供一种简便、无创、有效的定量检测方法。Objective To investigate the value of MR mDixon-Quant technology in accurately measuring the liver fat content of breast cancer patients after endocrine therapy,and analyze the clinical characteristics of patients with fatty liver.To early indicate the occurrence of fatty liver after endocrine therapy in breast cancer patients and the need for intervention treatment with the dynamic monitoring technology.Methods 73 breast cancer patients with positive hormone receptors after surgery and endocrine therapy for at least 2 years were enrolled in this study,which had the examination of liver 3.0T MR mDixon-Quant before and after treatment.Accurately measured the fat content of the liver and used the liver MR proton-density fat fraction(PDFF)greater than 6.4%as the diagnostic criteria for fatty liver in accordance with recommended standard in foreign literature.And according to the standard,fatty liver was divided into mild,moderate,and severe.The fasting venous blood samples were taken for liver function examination on the same day of MRI examination.The MRI PDFF values were compared and analyzed with the main indicators of liver function like alanine aminotransferase(ALT)and aspartate aminotransferase(AST).Results A total of 27 cases of fatty liver occurred in 73 cases of breast cancer after endocrine therapy in 2 years,the incidence was 36.9%(27/73),and the PDFF was 15.25±6.42%;the earliest time of occurrence of fatty liver was 3 months after endocrine therapy;the 27 cases of fatty liver were mainly mild and moderate,accounting for 81.5%(22/27);the PDFF of mild,moderate,and severe fatty liver were 8.76±2.21%,18.65±1.23%,24.00±1.12%,respectively.There were statistically significant differences in ALT and AST between before and after the occurrence of fatty liver as same as in different degrees of fatty liver group(P<0.05).PDFF of 27 patients with fatty liver showed increased liver fat content,but only 19 had abnormal liver function ALT and AST values,and the other 8 were still in the normal range.Conclusion The M

关 键 词：乳腺癌 磁共振成像 脂肪肝 肝功能 

分 类 号：R737.9[医药卫生—肿瘤]