摘要
常规方法检测肝脏ATP需要大量组织标本 ,在同一批动物或人体的重复检测是不可能的 ,并且不能监测早期或可逆性细胞损伤中的轻微新陈代谢变化。3 1PMRS是活体检测高能磷酸盐的唯一手段。无机磷 (Pi)与磷酸单酯 (PME)比率 (细胞生存和代谢的标志 )以及各种ATP可以重复定量检测。在细胞死亡和随后的器官病变之前 ,利用3 1PMRS ,可检测到早期轻微能量变化引起的β ATP明显减少 ,Pi/ β ATP比率减少以及PME/ β ATP比率的显著升高[1] 。在正常肝脏的波谱中 ,含磷总量的PME波峰为 4 .77% (可信区间CI:4 .11~ 5 .4 2 ) ,在轻度肝硬化 [5 .80 % (95 %CI:5 .4 6~ 6 .14 ) ,P =0 0 0 5 1,对正常肝 ]和重度肝硬化 [9.6 4 % (95 %CI:8.71~ 10 .5 7) ,P =0 .0 0 0 2 ,对正常肝和P =0 .0 0 1,对轻度肝硬化 ]明显升高[2 ] 。在对所有原发或继发肿瘤患者的研究中 ,PME/PDE比率是增加的 ,作者认为3 1PMRS是检测肝脏疾病进展和治疗效果的有效方法[3 ] 。
Conventional methods to assay hepatic ATP require large tissue samples, making repeat measurements on the same animal or human impossible, and are unable to monitor the minimal changes in metabolism consistent with early or reversible cellular injury. 31P MRS is a modality available for the in vivo measurement of high energy phosphates. Ratio of inorganic phosphate (Pi) and phosphomonoester (PME) (markers of cellular metabolism and viability) as well as fractionated ATP may be repeatedly quantitated. 31P MRS can detect the obvious decrease of beta-ATP, decrease of the ratio of Pi/beta-ATP and increase of the ratio of PME/beta-ATP due to the early subtle energy changes prior to cell death and subsequent organ failure with significant decreases. The phosphomonoester(PME) peak in normal human liver was 4.77%(95% confidence interval, CI:4.11~5.42) of total phosphorus. The PME peak was significantly elevated in both mild cirrhosis[5.80%(95% CI:5.46~6.14),P=0.0051, vs normal subjects] and severe cirrhosis[9.64%(95 CI:8.71~10.57),P=0.0002, vs normal subjects and P=0.001,vs mild cirrhosis].An increase in the PME/PDE was observed in the 31P hepatic MR spectrum from primary or secondary tumours in all studied patients. The authors conclude that the hepatic 31P-MR spectroscopy may be proved useful for monitoring disease processes and treatment effects in well-characterized patient populations.
出处
《医学影像学杂志》
2003年第11期868-871,共4页
Journal of Medical Imaging