3.0T HMRS定量评估脂肪肝疗效的优越性

摘要

目的：探讨3.0T磁共振HMR波谱（HMRS）成像技术在定量分析评估脂肪肝治疗效果中的临床应用。方法收集弥漫性脂肪肝患者39例，在干预治疗前及治疗后9个月，空腹行CT上腹部平扫，肝脏超声，MR双回波序列DUAL，常规横断位T2WI-TSE，T2WI-SPAIR，冠状位Balanced-FFE，及HMRS检查，通过分析计算HMRS图像在特定化学位点上的水峰（4.7ppm）、脂质峰（1.0～1.5ppm）的波峰峰值和波峰下面积，进行准确定量肝脏内脂质含量（intra hepatic content of lipid， IHCL），根据超声结果及CT的L/S值（肝脾CT值的比值）评估脂肪肝程度的标准，探讨HMRS在定量分析弥漫性脂肪肝疗效中的作用。结果超声及CT检查成功率100%，获得可用数据，HMRS检查成功率为97%，38例取得明确磁共振波谱成像，1例波谱成像基线不稳，杂峰较多，影响评价而被排除。结论超声以及CT检查均可有效检测脂肪肝严重程度，3.0T HMRS可更精确的定量分析脂肪肝的临床疗效。%Objective To investigate the clinical treatment effect of proton magnetic resonance spectroscopy(1 H-MRS) imaging,by which to quantitatively analyze liver fat content for therapeutic evaluation of fatty liver at 3.0 T MRI. Methods 39 patients on an empty stomach with diffused fatty liver underwent CT,B-Ultrasound and MR dual-echo chemical shift gradient-echo imaging simultaneously,T2WI-TSE,T2WI-SPAIR,Balanced-FFE and HMRS. The values of water peak(4.7ppm),lipid peak (1.0-1.5ppm)the area under water peak(Aw)and lipid peak(AL)were measured,accurate quantitative IHCL. According to the B-ultrasound and L/S,quantitatively analyzing liver fat content for therapeutic evaluation of fatty liver. Results The success rate was 100%in B-Ultrasound and CT. The success rate was 97%in HMRS,the data of 38 patients were available . Conclusion B-Ultrasound and CT are effective Methods. 3.0T HMRS is an more precise method in clinical application in quantitative diagnosis the therapeutic effect of fatty liver.