摘要
目的：探讨双回波同反相位（IP-OP）减影法及T2校正1H-MRS定量分析非酒精性脂肪肝患者的肝脂肪含量（LFC）的可行性。方法：对42例临床怀疑脂肪肝的患者行3D T1WI IP-OP成像结合减影技术及1H-MRS检查。选取5名患者行多次回波PRESS序列以测量水、脂的T2值。采用非参数Spearman分析及Mann-Whitney U检验，比较评价两种影像方法定量分析脂肪肝的能力。结果：1H-MRS各峰值采用T2进行校正（T2水=33.1 ms，T2亚甲基=64.2 ms）。IP-OP减影法、1H-MRS对脂肪肝定性诊断的敏感度及特异度分别为89.2%、100%及91.2%、100%。IP-OP减影法及1H-MRS测得的脂肪含量与病理结果均呈显著的相关性（r=0.80，0.92；P＜0.01）。1H-MRS可有效区分无脂肪肝与轻度脂肪肝（Z=-2.97，P＜0.01）、轻度与中度脂肪肝（Z=-3.72，P＜0.01）、中度与重度脂肪肝（Z=-3.25，P＜0.01），IP-OP减影法可有效区分无脂肪肝与轻度脂肪肝（Z=-2.54，P＜0.01）、轻度与中度脂肪肝（Z=-3.72，P＜0.01），不能区分中度与重度脂肪肝（Z=-1.77，P=0.08）。1H-MRS、IP-OP减影法测得的LFC均低于病理结果（除无脂肪肝组外，Z≤-2.21，P＜0.05）。结论：IP-OP减影法可简单快速的诊断脂肪肝程度，1H-MRS对脂肪肝的定量诊断具有更高的准确性。
Abstract
Objective: To compare the T1 weighted in-phase and out-of-phase magnetic resonance imaging(IP-OP) with subtraction techniques and T2 corrected proton 1H-MR spectroscopy(1H-MRS) in the assessment of liver fat content(LFC) in patients with nonalcoholic fatty liver disease. Methods: IP-OP MR imaging and 1H-MRS were performed in 42 patients using a 3T MR unit. Subtraction images were made from pairs of IP and OP images. T2 relaxation measurements were performed in five patients by using a multi echo PRESS sequence. LFC measured by IP-OP and 1H-MRS were compared with histological results using spearman analysis and Mann-Whitney U test. Results: LFC measured by 1H-MRS were corrected by T2 relaxation(T2water=33.1 ms, T2fat=64.2 ms). Sensitivity and specificity of IP-OP substraction and 1H-MRS to detect steatosis was 89.2%, 100% and 91.2%, 100%, respectively. IP-OP MR imaging and 1H-MRS measurements of LFC had strong correlation with histopathologic steatosis assessment(r=0.80, 0.92; P＜0.01). IP-OP and 1H-MRS showed differences across steatosis grades: none versus mild, mild versus moderate and moderate versus severe grade(expect that IP-OP cannot differentiate moderate from severe grade, Z≤-2.54, P＜0.01). The LFC measured by IP-OP and 1H-MRS were significantly lower than pathology(expect for non fatty liver group, Z≤-2.21, P＜0.05). Conclusion: IP-OP is a quick and effective way to detect steatosis for clinic. 1H-MRS has better diagnostic accuracy in depicting hepatic steatosis than IP-OP.
关键词
脂肪肝 /
磁共振成像 /
磁共振波谱学
Key words
Fatty liver /
Magnetic resonance imaging /
Magnetic resonance spectroscopy
石 喻;郭启勇;夏 菲;张 兰;卞胜昕.
同反相位图像减影技术及T2校正1H-MRS定量分析非酒精性脂肪肝的临床研究[J]. 中国临床医学影像杂志. 2012, 23(4): 248-252
SHI Yu;GUO Qi-yong;XIA Fei;ZHANG Lan;BIAN Sheng-xin.
Clinical evaluation of nonalcoholic fatty liver disease with in-phase and out-of-phase subtraction MR imaging and T2 corrected proton 1H-MR spectroscopy[J]. Journal of China Clinic Medical Imaging. 2012, 23(4): 248-252
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