氢质子磁共振波谱成像在肝纤维化分期诊断中的意义研究.pdfVIP

氢质子磁共振波谱成像在肝纤维化分期诊断中的意义研究

李晓栋;娄江华;李攀;孙明华;刘红明;李海婷

【摘要】目的研究氢质子磁共振波谱(1H-MRS)中脂质(Lip)和胆碱(Cho)峰值及

峰下面积数据在肝脏纤维化分期的应用.方法收集经组织学证实的肝纤维化患者55

例,对其进行1H-MRS成像,并计算脂质(Lip)和胆碱(Cho)峰值及峰下面积共4个参

数(Lip-Amp、Lip-Are、Cho-Amp、Cho-Are),分析其与肝纤维化分期之间的相

关性.结果55例患者中,S0期16例,S1期12例,S2期11例,S3期8例,S4期8

例,其脂质和胆碱峰值及峰下面积与其分期呈正相关.根据ROC曲线分析,单一参数

对于患者肝纤维化分期的灵敏度及特异性较低,而4个参数联合区分肝纤维化相邻

两区的ROC曲线下面积分别为0.875、0.848、0.830、0.813,具有较高的应用价

值.结论脂质和胆碱峰值及峰下面积联合诊断患者肝纤维化分期的效果要优于单一

指标.%ObjectiveToinvestigatetheapplicationofpeakvalueoflipid(Lip)

andcholine(Cho)inhydrogenprotonmagneticresonancespectroscopy

(1H-MRS)aswellasitsareaunderthepeakinthediagnosisofhepatic

ifbrosisstaging.MethodsSelected55hepaticifbrosispatientswhowere

diagnosedbyhistology,andthenthe1H-MRSimagingwasperformedon

them.Parametersasthepeakvalueandtheareaunderthepeakoflipand

choofeverypatient(Lip-Amp,Lip-Are,Cho-AmpandCho-Are)were

calculated.Analyzetheircorrelationwiththehepaticfibrosisstaging.

ResultsAmongallthe55patients,therewere16casesinstage0,12in

stage1,11instage2,8instage3andthesameforstage4,andtheirpeak

valueaswellastheareaunderthepeakoflipandchohadapositive

correlationwiththeirstaging.AccordingtotheROCcurve,itcanbe

observedthatsingleparameterhadrelativelylowsensitivityandspeciifcity

indiagnosisofhepaticifbrosisstagingwhiletheeffectgotbetterwhen

diagnosingwith4combinedparametersandthesensitivityandspeciifcity

ofcombineddiagnosiswere0.875,0.848,0.830,0.813,ithadgood

applicationvalue.ConclusionTheeffectofcombineddiagnosiswithpeak

valueandtheareaunderthepeakoflipandchohasbetterthanthatof

thesinglediagnosis.

【期刊名称】《中国继续医学教育》

【年(卷),期】2015(007)023

【总页数】3页(P64-66)

【关键词】磁共振波谱;肝纤维化分期;脂质;胆碱;ROC曲线

【作者】李晓栋;娄江华;李攀;孙明华;刘红明;李海婷

【作者单位】4