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氢质子磁共振波谱及磁共振R2*成像在肝纤维化诊断及分期中价值的初步探讨 被引量:6

Value of proton magnetic resonance spectroscopy(~1H-MRS) and R2* imaging in diagnosis and staging of liver fibrosis:a preliminary study
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摘要 目的:评估氢质子磁共振波谱(1H-MRS)、磁共振(MR)R2*成像在诊断肝脏纤维化中的应用价值,并确认其对肝纤维化分期(F0~F6)的准确性。方法:对24例经组织学证实的肝纤维化患者(平均年龄为33岁)和5例健康人(平均年龄为33岁)进行R2*成像、1H-MRS成像,计算正常肝脏及纤维化肝脏R2*值(8回波、16回波、16回波抑脂序列)、脂质(Lip)和胆碱(Cho)的峰值及峰下面积。结果:8回波、16回波R2*值、脂质峰值及峰下面积在不同肝纤维化各分期间差异具有统计学意义(P<0.05),并与肝纤维化分期存在正相关性,可以区分轻、中、重度肝纤维化。当诊断肝纤维化分期≥F3,Lip峰下面积(LipAre)、Lip峰值(LipAmp)及R2*(8回波)、R2*(16回波)、R2*(16回波抑脂)值的曲线下面积分别为0.967、0.900、0.844、0.833、0.778,特异度分别为86.7%、60.0%、73.3%、66.7%、80.0%,灵敏度为100%、100%、100%、100%、83.3%。当诊断肝纤维化分期≥F1,LipAre、LipAmp、R2*(8回波)、R2*(16回波)、R2*(16回波抑脂)值的曲线下面积分别为0.643、0.592、0.827、0.827、0.816,特异度分别为100%、71.4%、100%、85.7%、100%,灵敏度为57.1%、42.9%、71.4%、78.6%、64.3%。结论:1H-MRS、MRR2*成像可用于临床评估肝纤维化,是帮助区分轻(F0~F2)、中(F3~F4)、重度(F5~F6)肝纤维化较为灵敏及特异的检测方法,并可为检出需要进行治疗的临床明显肝纤维化患者提供诊断依据。 Objective To study the value of proton magnetic resonance spectroscopy(1H-MRS) and MR R2* imaging in diagnosis of liver fibrosis and to ascertain its accuracy in staging liver fibrosis(F0-F6).Methods Twenty-four pathologically proved liver fibrosis patients(mean age 33) and 5 healthy volunteers(mean age 33) were enrolled.R2* values(8 echo,16echo,16echo fat-suppressed),lipid peak value(Lip Amp),area under lipid peak(Lip Are) and choline peak value(Cho Amp),area under choline peak(Cho Are) were calculated.Results R2* values,Lip Amp and Lip Are differed significantly between different stages of liver fibrosis and were positively correlated with the stage of liver fibrosis.Mild,moderate and severe fibrosis could be distinguished with each other by these parameters.In advanced fibrosis(≥F3,clinical severe fibrosis,CSF),the values of Lip Are,Lip Amp and AUC of R2*(8 echo),R2*(16 echo),R2*(16 echo fatsuppressed) were 0.967,0.900,0.844,0.833,0.778,respectively;the specificity of these parameters were 86.7%,60.0%,73.3%,66.7%,80.0% and the sensitivity were 100%,100%,100%,100%,83.3%,respectively.In mild fibrosis(≥F1),the values of Lip Are,Lip Amp and AUC of R2*(8 echo),R2*(16 echo),R2*(16 echo fat-suppressed) were 0.643,0.592,0.827,0.827,0.816,respectively;the specificity of these parameters were 100%,71.4%,100%,85.7%,100% and the sensitivity were 57.1%,42.9%,71.4%,78.6%,64.3%,respectively.Conclusions 1H-MRS and MR R2* imaging were sensitive and specific in detecting liver fibrosis and distinguishing different stages of fibrosis(mild F0-F2,moderate F3-F4 and severe F5-F6).CSF patients needing treatment could be detected by 1H-MRS and MR R2* imaging.
出处 《诊断学理论与实践》 2010年第4期320-326,共7页 Journal of Diagnostics Concepts & Practice
关键词 肝纤维化 磁共振成像 磁共振波谱 诊断 Liver fibrosis Magnetic resonance imaging Magnetic resonance spectroscopy Diagnosis
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参考文献18

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二级参考文献34

共引文献53

同被引文献40

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