^1HMRS在定性诊断乙肝后早期肝硬化中的初步研究

^1HMR Spectroscopy in Qualitative Diagnosis of Forpart Hepetocirrhosis after Chronic Type B Hepatitis： Pilot Study

目的：研究慢性乙型肝炎后早期肝硬化患者的氢质子磁共振波谱图像特点，旨在探讨^1HMRS成像技术诊断慢乙肝后早期肝硬化的可行性，为早期肝硬化的定性诊断提供新的方法。方法：首先，筛选出15例健康志愿者及15例慢乙肝后早期肝硬化患者。并将15例患者依据肝穿结果分为S2期、S3期和S4期三组；然后，对15例健康志愿者及15例慢乙肝后肝硬化组患者进行常规MRI扫描，包括三平面定位，横断面T1加权像（T1WI）、T2加权像（T2WI），于T2WI上选取感兴趣区进行单体素氢质子波谱扫描。分别采集各化合物峰，通过GE公司波谱分析软件校正，测量各波峰峰值和峰下面积，分析正常组和病例组各波峰和峰下面积变化特征。结果：正常组均得到谷氨酸和谷氨酰氨复合物（glumatic acid and glutamylamnnia complex，GIX）峰与胆碱／磷酸肌酸（choline／phosphoric creatine acid，Cho／Pcr）峰，病例纽除上述两峰外，还得到乳酸（Lactate，Lac）峰和脂质（Lipid，Lip）峰。经统计学分析正常组与病例组Glx、Cho／Pcr峰值及峰下面积无明显差异（P〉0．05），而Lac、Lip峰值及峰下面积有差异统计学意义（P〈0.05）。病例组内的S2、S3及S4期三组各自的Glx、Cho／Pcr、Lac、Lip峰值及峰下面积差异无统计学意义（P〉0．05）。结论：1H磁共振波谱成像技术是一种非创伤性定性检测慢乙肝后早期肝硬化的方法。

Objective： To investigate the feasibility of qualitative detecting forepart hepatocirrhosis after chronic type B hepatitis by ^1H Magnetic resonance spectroscopy （MRS）. Method： First, we bolted 15 normal contrast and 15 patients with forepart hepatocirrhosis after chronic type B hepatitis, then divided the patients to three groups （S2, S3 and S4 stage） according to results of liver biopsy. All person were scanned by MR plain, including 3D localization, axial T1 weighted imaging （T1WI）, T2 weighted imaging（T2WI） and fast spin echo sequence（FSE）, The voxel position was chosen with T2WI and 1H MR imaging was underwent. At last, compound peaks were acquired respectively and corrected by spectroscopy analysis GE （functool） software. The peak values were measured, the areas under the peaks were calculated and the features of normal contrasts and patients with forepart hepatocirrhosis after chronic type B hepatitis were analyzed by the software. Results： Glumatic acid and glutamylamnnia complex （Glx） peak and Choline/phosphoric creafine acid （Cho/Pcr） peak appeared in the normal group. Cases group acquired Lactate （Lac） peak and Lipid （Lip） peak except above two peaks. Glx peak and Cho/Pcr peak had not obvious difference between these patients with forepart hepatocirrhosis after chronic type B hepatitis groups and normal contrasts groups （P〈0.05）, but Lac peak and Lip peak had obvious difference （P〈0.05）. Cases group could be separated to S2, S3 and S4 stage according to results of liver biopsy, respective peak and the area under the peaks of GLX, Cho/pcr, Lac and Lip had not significant difference （P〉0.05）. Conclusion： ^1H MR spectroscopy in qualitative diagnosis of forpart hepetocirrhosis after chronic type B hepatitis was feasible. It method of detecting forepart hepetocirrhosis after chronic type B hepatitis.