3.0T ^1H-MRS与超声在非酒精性脂肪肝随访价值的对比研究

The Comparative Study of the Follow up Value of 3. 0 T ^1H-MRS and Ultrasonography in Nonalcoholic Fatty Liver Disease

目的以脂肪肝患者的临床生化指标为标准,对比氢质子磁共振波谱(1H-MRS)定量分析和超声半定量分析在非酒精性脂肪肝(NAFLD)随访中的价值。方法选择30例健康体检中经影像学确诊的NAFLD患者,且体重指数(BMI)>25 kg/m2、甘油三酯(TG)>1.7 mmol/L,同期行肝脏1H-MRS扫描及超声检查,1H-MRS计算肝细胞相对脂肪含量(RLC),超声采用记分法进行半定量;将患者分为对照组15例,保持原有日常生活;干预组15例,给予临床干预,包括运动、低脂饮食,6个月后随访1H-MRS、超声、TG及BMI,以BMI、TG为参照,对随访前后RLC和超声记分进行对比分析。结果干预组6个月后随访RLC、BMI和TG均值较干预前下降,随访前后差异具有统计学意义(P<0.05),超声记分均值相对6个月前差异无统计学意义(P>0.05);对照组RLC、超声记分、BMI和TG均值随访前后差异均无统计学意义(P>0.05)。结论随访前后干预组和对照组RLC的变化均与临床生化指标BMI、TG的变化趋势一致,而干预组和对照组超声记分在6个月前后均无显著差异,与BMI、TG的变化不完全一致;因此3.0 T1H-MRS定量评价肝脏脂肪含量在NAFLD疗效随访中较超声记分法更为客观、准确。

Objective Taking the clinical and biochemical indexes of fatty liver patients as the standard,to make comparison the follow up value between the proton magnetic resonance spectroscopy（1H-MRS） quantitative analysis and ultrasonography semi quantitative analysis in nonalcoholic fatty liver disease（ NAFLD）. Methods Selected 30 cases of healthy check-up patients who were diagnosed as NAFLD by imageology,and the body mass index（ BMI） was more than25 kg / m2,the triglyceride（ TG） was more than 1. 7 mmol/L,meanwhile,undertook the liver1H-MRS scanning and ultrasonography,calculated the relative lipid content（ RLC） of liver cells on the basis of1H-MRS,the ultrasonic examination adopted a scoring method to undertake the semi quantitative assessment; divided the patients for the control group for 15 cases and maintained the original daily life,The intervention group for 15 cases and gave the clinical intervention including sports,low fat diet,after 6 months undertook the follow up1H-MRS,ultrasonography,TG and BMI. Took BMI,TG as the reference,made comparison and analysis of RLC and ultrasonic score before and after follow up. Results The 6 months later follow up mean of RLC,BMI and TG for the intervention group decreased compared with those before intervention,the around follow up differences were statistically significant（ P 〈 0. 05）. The mean of ultrasonic score didn’t change significantly compared with 6 months ago（ P 〉 0. 05）; for the comparison group,the around follow up difference had no statistical significance for the mean of RLC,ultrasonic score,BMI and TG（ P 〉 0. 05）. Conclusion There were similar trend of change around follow up between RLC and the clinical biochemical indexes BMI,TG in both groups. But there were no significant changes between the 6 months around ultrasonic score in both groups,and not total similar trend of change with BMI and TG. In consequence,3. 0T1H-MRS quantitative assessment of liver fat content was more objective and accurate than the ultrasonic scoring method in the monitoring of the therapeutic effect of NAFLD.