摘要
目的以组织病理为标准,比较氢质子磁共振波谱(1H-MRS)、双梯度回波磁共振成像(DGE-MRI)、CT诊断及定量分析肝脏脂肪变的准确性。方法 52例弥漫性非酒精性脂肪肝患者均于肝穿刺活检前1～2天行1H-MRS、DGE-MRI及CT扫描。以病理结果为金标准,比较1H-MRS、DGE-MRI、CT在肝细胞脂肪变(5%≤脂肪变肝细胞≤30%)和脂肪肝(脂肪变肝细胞>30%)中的诊断价值以及定量分析的准确性。结果 52例患者中,FO级19例,F1级11例,F2级12例,F3级6例,F4级4例;不同病理级别间LWR、HFF及LSR均数差异均有统计学意义(H值分别为39.423,26.799,24.440,P值均<0.05)。1H-MRS诊断肝细胞脂肪变的Youden指数(0.727)明显高于DGE-MRI和CT(0.490、0.368)。1H-MRS、DGE-MRI诊断脂肪肝的Youden指数分别为0.809,0.764,明显高于CT(0.236)。结论1H-MRS是评估非酒精性脂肪肝的最佳无创性检查方法,有望取代有创的肝活检。
Objective To compare the accuracy of proton magnetic resonance spectroscopy（1 H-MRS）,dual gradient echo magnetic resonance imaging（DGE MRI） and computed tomography（CT） for the diagnosis and quantitative estimation of hepatic steatosis（HS）.Methods A total of 52 patients with nonalcoholic diffusely fatty liver disease（NAFLD） underwent 1 H-MRS,DGE MRI and CT before the liver biopsy,the histopathological results was used as the reference standard,the diagnostic accuracy of 1 H-MRS,DGE MRI and CT for diagnosing 5%≤HS≤30% and HS30% and the quantitative estimation of HS between 1 H-MRS,DGE MRI,and CT were compared.Results In all 52 patients,the cases of F0,F1,F2,F3 and F4 were 19,11,12,6 and 4,respectively.Inter comparison among different histopathological degree showed that the values of LWR,HFF and LSR had statistical significance（H values were 39.423,26.799,24.440,respectively,P0.05）.The Youden index of 1 H-MRS for diagnosing 5%≤HS≤30% was 0.727,which higher than that of DGE MRI（0.490） and CT（0.368）.The Youden index of 1 H-MRS and DGE MRI for diagnosing HS30% were 0.809,0.764,respectively,which higher than that of CT（0.236）.Conclusion 1 H-MRS may be the most optimal examination for the noninvasive assessment of HS,and liver biopsy may be replaced by it.
出处
《临床放射学杂志》
CSCD
北大核心
2012年第11期1578-1582,共5页
Journal of Clinical Radiology
基金
福建省自然基金资助项目(编号:2010J01153)
关键词
肝脏脂肪变
磁共振成像
磁共振波谱
体层摄影术
X线计算机
Hepatic steatosis Magnetic resonance imaging Magnetic resonance spectroscopy Tomography
X-ray computed
