1H-MRS动态监测乳腺癌患者化疗后的肝脏脂肪含量的变化

目的:探讨磁共振氢质子波谱成像监测乳腺癌患者化疗后的肝脏脂肪含量变化的可行性及脂肪含量的变化规律?方法:在GE1.5T磁共振仪上使用单体素点分辨波谱序列加呼吸门控技术,对30例乳腺癌术后行化疗的患者,分别于化疗前,化疗第3?6个疗程结束后进行肝脏磁共振氢质子波谱成像,采用 jMRUI软件包测定水峰和脂质峰峰下面积,计算肝细胞内相对脂肪含量?结果:30例患者中,26例随着疗程的进展,肝脏的脂肪含量增加,其中21例化疗前即出现脂峰,肝脏平均脂肪含量在化疗前为(5.59 ± 4.86)%,3个疗程结束后为(8.79 ± 6.02)%,6个疗程结束后为(15.81 ± 10.73)%,两两比较有统计学差异;另外5例化疗前无脂峰出现,随疗程的进展出现脂峰?有4例在整个化疗过程中肝脏的脂肪含量无变化(无明显脂峰的出现,仅有水峰出现)?结论:乳腺癌患者化疗过程中脂肪含量逐渐增加?磁共振氢质子波谱分析可以无创动态监测肝脏脂肪含量的变化,发现化疗相关的肝脏损害?

Using 1H magnetic resonance spectroscopy to monitor liver fat changes due to chemotherapy in breast cancer patients

Objective:To explore the feasibility of monitoring liver fat content changes by proton maganetic resonance spectroscopy (1H-MRS) in patients with cancer of mammary gland. Methods:Thirty patients with breast cancer who were receiving postoperative chemotherapy were included. 1H-MRS was acquired before chemotherapy,after three or six cycles treatment. All scans were performed on GE 1.5T MRI system using point-resolved-spectroscopy sequence,and breathing gating were employed. Fat content was calculated by measuring the areas of water and lipid peaks using jMRUI software package. Results:Hepatic fat content increased in 26 patients (26/30) after treatement. Among these patients 21 cases had lipid peak before treatment and the value increased from(5.59 ± 4.86)% to (8.79 ± 6.02)% after three cycles,and reached(15.81 ± 10.73)% after six cycles of treatment. The other 5 patients who had no lipid peak before chemotherapy showed lipid peak during treatment. There were 4 cases (4/30) without showing lipid peak during the whole chemotherapy course. Conclusion:Hepatic fat content increased during chemotherapy in breast cancer patients. 1H-MRS provides a noninvasive tool to monitor hepatic fat content change and detect chemotherapy related liver toxicity.