运用MR mDIXON-Quant技术和IP-OP进行非酒精性脂肪肝病脂肪定量分析的可行性研究

Feasibility study on quantitative analysis of NAFLD fat using 3.0T MR mDIXON-Quant technology and IP-OP

目的 探讨MR mDIXON-Quant技术及IP-OP序列对成人非酒精性脂肪性肝病(NAFLD)肝脏脂肪定量分析的可行性。方法 选取51例成人NAFLD患者临床及MRI资料为观察组,选取同期健康志愿者22例为对照组。所有入组患者进行3.0T MR mDIXON-Quant检查及IP-OP检查,同时一周内进行上腹部CT检查,测量CT肝/脾比值,作为脂肪肝的诊断标准;对mDIXON-Quant序列及IP-OP序列的肝脏脂肪定量数据结果进行统计学分析。结果 1)mDIXON-Quant技术,对照组与观察组的HFF差异有统计学意义(P<0.001);IP-OP序列,对照组与观察组的HFC差异有统计学意义(P<0.001);HFF、HFC与肝脾CT比值呈负相关(r=-0.974、P<0.001,r=-0.972、P<0.001);2)ROC曲线分析,HFF及HFC均可以诊断脂肪肝,AUC均>0.5。对于轻中度脂肪肝,HFF敏感度高于HFC,特异度低于HFC;但对于重度脂肪肝,二者敏感度均为1,特异度HFF高于HFC。结论 MRI mDIXON-Quant技术及IP-OP序列对NAFLD肝脏的脂肪含量进行定量评估是可行的,并与肝脾CT值比较具有良好的相关性,MRI mDIXON-Quant技术在对轻中度脂肪肝的脂肪含量测定方面敏感度高于IP-OP序列,在重度脂肪肝组特异度高于IP-OP序列。

Objective To investigate the feasibility of MR mDIXON-Quant technique and IP-OP sequence for quantitative analysis of liver fat in adult nonalcoholic fatty liver disease(NAFLD).Methods A total of 73 cases were collected,including 51 cases in the experimental group(33 males and 18 females),and 22 cases in the control group(10 males and 12 females).All enrolled patients underwent 3.0T MR mDIXON-Quant examination and IP-OP examination,and upper abdominal CT examination within one week.The CT liver/spleen ratio was measured as the diagnostic standard of fatty liver;The quantitative data of liver fat of mDIXON-Quant sequence and IP-OP sequence were statistically analyzed.Results 1)The difference of HFF between control group and fatty liver group was statistically significant(P<0.001);As for IP-OP sequence,HFC in control group and fatty liver group was statistically significant(P<0.001);There was a negative correlation between HFF,HFC and CT value ratio of liver and spleen(r=-0.974,P<0.001,r=-0.972,P<0.001).2)ROC curve analysis showed that HFF and HFC could diagnose fatty liver,and AUC was greater than 0.5.For mild to moderate fatty liver,the sensitivity of HFF was higher than that of HFC,and the specificity was lower than that ofHFC;However,for severe fatty liver,the sensitivity and specificity of both were 1,and HFF was higher than HFC.Conclusion MR mDIXON-Quant technique and IP-OP sequence are feasible to quantitatively evaluate the fat content of NAFLD liver,and have a good correlation with the ratio of liver and spleen CT value.MR mDIXON-Quant technique is more sensitive than IP-OP sequence in the determination of fat content of mild and moderate fatty liver,and more specific than IP-OP sequence in severe fatty liver group.