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目的探讨3.0 T磁共振氢波谱成像(1H-MRS)在定量评价肝脏脂肪含量中的价值。方法前瞻性纳入22例可获得肝脏标本的患者(活体肝移植供体候选者、部分需作肝段/肝叶切除的肝病患者等)作为研究对象,采用点分辨选择性波谱序列(point resolved selective spectroscopy,PRESS)对研究对象的肝脏行1H-MRS检查,采用SAGE软件包测定水峰峰值(PW)、脂峰峰值(PL)、水峰峰下面积(AW)及脂峰峰下面积(AL),计算肝细胞相对脂肪含量1(relative lipid content one,RLC1)及肝细胞相对脂肪含量2(relative lipid content two,RLC2)。于MR扫描后当日至1周内通过手术获取肝脏标本,并对标本进行组织学检查,对肝脏脂肪含量进行分级,并将影像学数据与病理结果对照研究。结果22例患者中,7例无脂肪肝,11例轻度脂肪肝,4例中重度脂肪肝;不同病理级别间比较,PL、AL、RLC1及RLC2的差异均有统计学意义(P<0.05),随着病理分级升高,对应的各指标的值也相应升高;PL、AL、RLC1及RLC2与脂变细胞百分含量(proportion of fatty degenerative cells,PFDC)之间存在线性正相关关系(P<0.05),以RLC1的相关系数最高(0.771 3)。结论1H-MRS能够较精确地反应脂肪肝的严重程度,有望替代有创性的肝穿刺活检。
Objective To investigate the value of 3.0 T magnetic resonance spectroscopy (1H-MRS) in the quantitative evaluation of liver fat content. METHODS: Twenty-two patients with liver specimens (those candidates for living donor liver transplantation and some patients with liver disease who underwent hepatectomy / hepatectomy) were prospectively enrolled in this study. Point-resolved selective sequence analysis (PW), fat peak (PL), area under the water peak (AW) and area under the lipid peak (ALP) were measured by 1H-MR spectroscopy (PRESS) ), Relative lipid content one (RLC1) and relative lipid content two (RLC2) were calculated. Liver samples were obtained surgically from 1 day to 1 week after MR scan. Histological examination was performed on the specimens to classify the liver fat content. The imaging data were compared with the pathological findings. Results Among the 22 patients, there were 7 cases of non-fatty liver, 11 cases of mild fatty liver and 4 cases of moderate-severe fatty liver. The differences of PL, AL, RLC1 and RLC2 between different pathological grades were statistically significant (P <0.05 ). With the increase of the pathological grade, the values of each index increased correspondingly. There was a linear positive correlation between PL, AL, RLC1 and RLC2 and the proportion of fatty degenerative cells (PFDC) (P <0.05), and the correlation coefficient of RLC1 was the highest (0.771 3). Conclusion 1H-MRS can more accurately reflect the severity of fatty liver, is expected to replace invasive biopsy of liver biopsy.