3.0 T 1H-MRS定量分析評估脂肪肝治療效果的初步研究_《中國普外基礎與臨床雜志》

作者：

張羲娥 ^1,2 , 劉曦嬌 ¹ , 黃子星 ¹ , 袁放 ¹ ,  宋彬 ¹ , 張威 ¹

1.四川大學華西醫院放射科(四川成都 610041);;
2.成都市第二人民醫院放射科(四川成都 610017);

關鍵詞：

脂肪肝功能性磁共振成像氫質子磁共振波譜成像

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目的探討在3.0 T MRI中運用氫質子波譜成像(1H-MRS)技術評估脂肪肝治療效果的可行性。方法收集臨床確診并治療的脂肪肝患者26例，分別于治療前、治療后3和6個月各行1次 1H-MRS檢查，測得 1H-MRS的水峰峰值和脂肪峰峰值、水峰峰下面積和脂肪峰峰下面積，計算肝細胞相對脂肪含量1(RLC1)及相對脂肪含量2(RLC2); 同期測量患者的甘油三酯、γ-谷氨酰轉肽酶、腹圍及體重指數，將其擬合成臨床脂肪肝指數(fatty liver index，FLI)。以FLI為參照標準，對不同時間點 1H-MRS所測得肝臟脂肪含量進行統計學分析。結果采用配伍設計的方差分析，治療前、治療后3和6個月的RLC1、RLC2值比較差異有統計學意義(P lt;0.05); 用SNK法做兩兩檢驗，治療前RLC1、RLC2值均分別明顯高于治療后3個月或治療后6個月的RLC1、RLC2值(P lt;0.05)。RLC1、RLC2與FLI進行秩相關性分析，均呈正相關性(r=0.476，P lt;0.001; r=0.475，P lt;0.001)。可靠性分析顯示，治療前的組內相關系數均≥0.75，可重復性好。結論1H-MRS定量分析評估脂肪肝治療效果具有可行性，并且是一種無創的定量監測方法。

引用本文： 張羲娥,劉曦嬌,黃子星,袁放,宋彬,張威. 3.0 T 1H-MRS定量分析評估脂肪肝治療效果的初步研究. 中國普外基礎與臨床雜志, 2011, 18(12): 1330-1333. doi: 復制

1.	Bedogni G, Bellentani S, Miglioli L, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population [J]. BMC Gastroenterol, 2006, 6: 3339.
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3.	向國卿, 孟憲云, 張浩, 等. 脂肪肝相關危險因素的評估 [J]. 世界華人消化雜志, 2009, 17（10）: 10381041.
4.	Hourigan KJ, Bowling FG. Alcoholic liver disease: a clinical series in an Australian private practice [J]. J Gastroenterol Hepatol, 2001, 16(10): 11381143.
5.	NeuschwanderTetri BA. Fatty liver and nonalcoholic steatohepatitis [J]. Clin Cornerstone, 2001, 3(6): 4757.
6.	Angulo P. GI epidemiology: nonalcoholic fatty liver disease [J]. Aliment Pharmacol Ther, 2007, 25(8): 883889.
7.	倪燕君, 劉厚鈺, 胡德昌, 等. 脂肪肝臨床病理分析 [J]. 中華消化雜志, 2001, 21（2）: 98101.
8.	Diehl AM. Nonalcoholic steatohepatitis [J]. Semin Liver Dis, 1999, 19(2): 221229.
9.	Targher G, Arcaro G. Nonalcoholic fatty liver disease and increased risk of cardiovascular disease [J]. Atherosclerosis, 2007, 191(2): 235240.
10.	Graif M, Yanuka M, Baraz M, et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease [J]. Invest Radiol, 2000, 35(5): 319324.
11.	李文政, 彭光春, 湯恢煥, 等. 脂肪肝CT、MRI定量診斷的對照實驗研究 [J]. 醫學影像學雜志, 2005, 15（4）: 294297.
12.	盛明洪, 呂斌, 周興祥, 等. 二維超聲圖像定量診斷脂肪肝病變程度的應用研究 [J]. 臨床超聲醫學雜志, 2005, 7（1）: 1820.
13.	Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver [J]. AJR Am J Roentgenol, 2007, 188(5): 13071312.
14.	劉云霞, 王潔貞, 劉建平, 等. 脂肪肝影像學診斷性試驗的系統評價 [J]. 中國醫學科學院學報, 2004, 26（5）: 580584.
15.	許驊, 王嵩, 耿道穎, 等. CT定量分析脂肪肝的臨床應用初探 [J]. 中國醫學計算機成像雜志, 2004, 10（4）: 250253.
16.	Sanyal AJ; American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease [J]. Gastroenterology, 2002, 123(5): 17051725.
17.	Borra RJ, Salo S, Dean K, et al. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with inphase and outofphase Mr imaging [J]. Radiology, 2009, 250(1): 130136.
18.	Rinella ME, McCarthy R, Thakrar K, et al. Dualecho, chemical shift gradientecho magnetic resonance imaging to quantify hepatic steatosis: Implications for living liver donation [J]. Liver Transpl, 2003, 9(8): 851856.
19.	Cassidy FH, Yokoo T, Aganovic L, et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis [J]. Radiographics, 2009, 29(1): 231260.
20.	FriedrichRust M, Müller C, Winckler A, et al. Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MRspectroscopy, and serum markers [J]. J Clin Gastroenterol, 2010, 44(1): 5865.
21.	Machann J, Thamer C, Schnoedt B, et al. Hepatic lipid accumulation in healthy subjects: a comparative study using spectral fatselective MRI and volumelocalized 1HMR spectroscopy [J]. Magn Reson Med, 2006, 55(4): 913917.
22.	趙黎明, 宋彬, 陳光文, 等. 肝臟脂肪含量MRI定量診斷與病理對照研究 [J]. 中國普外基礎與臨床雜志, 2011, 18（6）: 666671.
23.	Kim H, Taksali SE, Dufour S, et al. Comparative MR study of hepatic fat quantification using singlevoxel proton spectroscopy, twopoint dixon and threepoint IDEAL [J]. Magn Reson Med, 2008, 59(3): 521527.
24.	Ricci PE, Pitt A, Keller PJ, et al. Effect of voxel position on singlevoxel MR spectroscopy findings [J]. AJNR Am J Neuroradiol, 2000, 21(2): 367374.

1. Bedogni G, Bellentani S, Miglioli L, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population [J]. BMC Gastroenterol, 2006, 6: 3339.
2. 范建高, 李新建, 朱軍, 等. 上海市成人代謝綜合征與脂肪肝關系分析 [J]. 中華內分泌代謝雜志, 2005, 21（4）: 306309.
3. 向國卿, 孟憲云, 張浩, 等. 脂肪肝相關危險因素的評估 [J]. 世界華人消化雜志, 2009, 17（10）: 10381041.
4. Hourigan KJ, Bowling FG. Alcoholic liver disease: a clinical series in an Australian private practice [J]. J Gastroenterol Hepatol, 2001, 16(10): 11381143.
5. NeuschwanderTetri BA. Fatty liver and nonalcoholic steatohepatitis [J]. Clin Cornerstone, 2001, 3(6): 4757.
6. Angulo P. GI epidemiology: nonalcoholic fatty liver disease [J]. Aliment Pharmacol Ther, 2007, 25(8): 883889.
7. 倪燕君, 劉厚鈺, 胡德昌, 等. 脂肪肝臨床病理分析 [J]. 中華消化雜志, 2001, 21（2）: 98101.
8. Diehl AM. Nonalcoholic steatohepatitis [J]. Semin Liver Dis, 1999, 19(2): 221229.
9. Targher G, Arcaro G. Nonalcoholic fatty liver disease and increased risk of cardiovascular disease [J]. Atherosclerosis, 2007, 191(2): 235240.
10. Graif M, Yanuka M, Baraz M, et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease [J]. Invest Radiol, 2000, 35(5): 319324.
11. 李文政, 彭光春, 湯恢煥, 等. 脂肪肝CT、MRI定量診斷的對照實驗研究 [J]. 醫學影像學雜志, 2005, 15（4）: 294297.
12. 盛明洪, 呂斌, 周興祥, 等. 二維超聲圖像定量診斷脂肪肝病變程度的應用研究 [J]. 臨床超聲醫學雜志, 2005, 7（1）: 1820.
13. Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver [J]. AJR Am J Roentgenol, 2007, 188(5): 13071312.
14. 劉云霞, 王潔貞, 劉建平, 等. 脂肪肝影像學診斷性試驗的系統評價 [J]. 中國醫學科學院學報, 2004, 26（5）: 580584.
15. 許驊, 王嵩, 耿道穎, 等. CT定量分析脂肪肝的臨床應用初探 [J]. 中國醫學計算機成像雜志, 2004, 10（4）: 250253.
16. Sanyal AJ; American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease [J]. Gastroenterology, 2002, 123(5): 17051725.
17. Borra RJ, Salo S, Dean K, et al. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with inphase and outofphase Mr imaging [J]. Radiology, 2009, 250(1): 130136.
18. Rinella ME, McCarthy R, Thakrar K, et al. Dualecho, chemical shift gradientecho magnetic resonance imaging to quantify hepatic steatosis: Implications for living liver donation [J]. Liver Transpl, 2003, 9(8): 851856.
19. Cassidy FH, Yokoo T, Aganovic L, et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis [J]. Radiographics, 2009, 29(1): 231260.
20. FriedrichRust M, Müller C, Winckler A, et al. Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MRspectroscopy, and serum markers [J]. J Clin Gastroenterol, 2010, 44(1): 5865.
21. Machann J, Thamer C, Schnoedt B, et al. Hepatic lipid accumulation in healthy subjects: a comparative study using spectral fatselective MRI and volumelocalized 1HMR spectroscopy [J]. Magn Reson Med, 2006, 55(4): 913917.
22. 趙黎明, 宋彬, 陳光文, 等. 肝臟脂肪含量MRI定量診斷與病理對照研究 [J]. 中國普外基礎與臨床雜志, 2011, 18（6）: 666671.
23. Kim H, Taksali SE, Dufour S, et al. Comparative MR study of hepatic fat quantification using singlevoxel proton spectroscopy, twopoint dixon and threepoint IDEAL [J]. Magn Reson Med, 2008, 59(3): 521527.
24. Ricci PE, Pitt A, Keller PJ, et al. Effect of voxel position on singlevoxel MR spectroscopy findings [J]. AJNR Am J Neuroradiol, 2000, 21(2): 367374.

《中國普外基礎與臨床雜志》

3.0 T 1H-MRS定量分析評估脂肪肝治療效果的初步研究

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《中國普外基礎與臨床雜志》

3.0 T 1H-MRS定量分析評估脂肪肝治療效果的初步研究

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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