3.0T^1H-MRS在正常肝脏与脂肪肝的对照研究

The Preliminary Study of Metabolite Quantitative of Normal Livers and Hepatic Steatosis using 3.0 T 1~H-MRS

目的采用3.0 T多射频核磁共振仪对正常志愿者及脂肪肝患者行氢质子磁共振波谱(1H-MRS)检查,探讨其对脂肪肝的诊断价值。方法招募38名正常志愿者,男19名,女19名,年龄25～75岁,平均(41.22±14.67)岁。27例脂肪肝患者,男17例,女10例,年龄25～62岁,平均(45.86±9.49)岁。采用3.0 T磁共振仪对所有正常志愿者及脂肪肝患者行肝脏1H-MRS扫描。统计所有肝脏1H-MRS谱线其水峰峰值、水峰峰下面积、脂峰峰值、脂峰峰下面积及脂肪分数,分别按年龄和性别分组,并采用SPSS 11.5统计分析软件进行统计学比较分析。结果同年龄组正常志愿者与脂肪肝患者间比较,除水峰峰值差别不明显外,其水峰下面积、脂峰峰值、脂峰下面积及脂肪分数差异均存在统计学意义(P水峰下面积(正常VS脂肪肝)=0.004,P脂峰峰值(正常VS脂肪肝)=0.00395,P脂峰峰下面积(正常VS脂肪肝)=0.001,P脂肪分数(正常VS脂肪肝)=0.000000033,P均<0.05);男性组正常志愿者与脂肪肝患者水峰峰值差别不明显,余代谢物数值差异均存在统计学意义;女性组正常志愿者与脂肪肝患者代谢物数值差异均有统计学意义(P水峰峰值(正常VS脂肪肝)=0.04,P水峰下面积(正常VS脂肪肝)=0.03,P脂峰峰值(正常VS脂肪肝)=0.000687,P脂峰峰下面积(正常VS脂肪肝)=0.000514,P脂肪分数(正常VS脂肪肝)=0.000406,P均<0.05);正常肝脏与脂肪肝MRS代谢物阈值:脂肪峰值为9.55(敏感性0.909,1-特异性0),脂肪峰下面积为8.65(敏感性0.955,1-特异性0.029),脂肪分数4.97%(敏感性0.955,1-特异性0.029)。结论 3.0 T1H-MRS可应用于正常肝脏及脂肪肝的定量研究;正常肝脏与脂肪肝MRS代谢物阈值提出对肝脏脂肪变性诊断提供客观、科学的参考价值。

Objective To investigate the value of proton magnetic resonance spectroscopy（ ^1 H-MRS） in diagnosing he- patic steatosis. Methods 38 normal volunteers, （ 19 males and 19 females, from 25 to 75 years old with mean age of41.22±14.67 years old） and 27 hepatic steatosis patients （ 17 males and 10 females, from 25 to 62 years old with mean age of 45.86±9.49 years old） underwent 3 T MRI examination. The volunteers and hepatic steatosis patients were divid- ed into groups by age：≥45 years old and 〈 45 years old, and by gender：male or female group. All volunteers and hepatic steatosis patients underwent 3 T 1H-MRS. The values of water peak, lipid peak and area under peak were measured , and fat fraction was calculated. Results In the same age group（≥45 years old or 〈45 years old group）, The area under wa- ter peak, the values of lipid peak, area under lipid peak and fat fraction had statistical difference between normal volunteers and hepatic steatosis patientsin. In the female group, there were statistical difference between volunteers and patients in ar- ea under water peak, the values of lipid peak, area under lipid peak and fat fraction. In the male group, all the data had statistical difference except the value of water peak. The ^1 H-MRS thresholds of lipid peak, area under lipid peak and fat fraction between normal liver and hepatic steatosis patients were 9.55 （sensitivity 0. 909, specificity 0）, 8.65 （sensitivity 0.955, specificity 0.029）, 4.97% （ sensitivity 0. 955, specificity 0.029）, respectively. Conclusion 3.0 T ~H-MRS can be used to accurately quantify normal liver and hepatic steatosis. The ^1H-MRS thresholds show important value in the diag- nosis of liver metabolic disease.