3.0T磁共振^1H-MRS诊断非酒精性脂肪肝的临床应用价值

目的探讨3.0T磁共振1H-MRS成像技术定量检测肝内脂肪含量并分析其与血清学指标的相关性,以评价3.0T磁共振1H-MRS技术在诊断非酒精性脂肪肝临床应用价值。方法对63例非酒精性脂肪肝患者及60名健康志愿者行常规MRI扫描及1H-MRS检查,扫描当日清晨均空腹采静脉血检测血清甘油三酯（TG）、总胆固醇（TC）及高密度脂蛋白胆固醇（HDL-C）含量。1HMRS检查得到水峰峰值、脂峰峰值、水峰峰下面积及脂峰峰下面积,以脂峰峰下面积/（脂峰＋水峰）峰下面积表示肝细胞相对脂肪含量,并比较其与血清学检查各项指标的一致性。结果健康对照组与脂肪肝组的甘油三酯（TG）、总胆固醇（TC）及高密度脂蛋白胆固醇（HDL-C）值差异有统计学意义（P〈0.05）;健康对照组及脂肪肝组的脂峰峰下面积、脂峰峰下面积/（脂峰＋水峰）峰下面积比值差异有统计学意义（P〈0.05）;脂肪肝组的脂峰峰下面积/（脂峰＋水峰）峰下面积比值与血清甘油三酯（TG）、总胆固醇（TC）值呈显著正相关（r=0.758、0.823,P〈0.05）,而与高密度脂蛋白胆固醇（HDL-C）值呈负相关（r=-0.632,P〈0.05）。结论 1H-MRS成像技术对定量检测非酒精性脂肪肝脂质代谢变化具有重要的临床应用价值,并在临床血清学检测之间具有良好的相关性。

Clinical Application Value of 3.0T 1H-MRS in Diagnosis of Non-alcoholic Fatty Liver

Objective To investigate the clinical application value of 1H-MRS in quantitative detection of lipid content in non-alcoholic fatty liver. Methods A total of 63 patients with non-alcoholic fatty liver and 60 healthy volunteers underwent 1H-MRS analysis and conventional MRI. The fasting venous blood lipid （TG、TC、HDL-C） were tested on the same day. The values of H2O peak and lipid peak and areas under the H2O peak and lipid peak were measured on 1H-MRS. The relative lipid content was calculated and compared with the results of the blood lipid. Results There were significant differences in TG, TC, HDL-C level, areas under the H2O peak and lipid peak and the relative lipid content between the two groups. There were significant positive correlation between the relative lipid content and TG, TC level （r=0.758、0.823,P〈0.05）, and significant negative correlation between the relative lipid content and HDL-C level in the fatty liver group （r=-0.632,P〈0.05）. Conclusion 1H-MRS is a very important technique for quantitatively assessment of the metabolism of lipid in the NAFLD patients.