The Research Of Clinical Application Of Quantitative Metabolites Of Liver By3.0T MRS And DWI

Part1The preliminary study of metabolite quantitative of normal liversand diagnostic of steatosis by3.0T1H-MRSObjective: To investigate the value of proton magnetic resonancespectroscopy(1H-MRS) on the quantification of normal hepatic and diagnosticof steatosis by3.0T MRI.Methods:38normal volunteers, including19males and19females,from25to75years old with mean age41.22±14.67years old and27hepaticsteatosis patients,17males and10females, from25to62years old withaverage age45.86±9.49years.The volunteers and hepatic steatosis patientsgroups were divided by age:≥45years old and <45years old, and bygender:male or female group. All volunteers underwent3T MRS, and16normal volunteers were scanned twice with the same position and the samesize of VOI.The values of water peak, area under water peak, the values oflipid peak and area under lipid peak of1H-MRS were measured by3.0T MRIand calculated fat fraction, then all datas were analysed.Results:①16normal volunteers were scanned twice with the sameposition and the same size of VOI, the results of3T MRS showed no statisticaldifference (p>0.05).②There were no statistical difference in the values ofwater peak, area under water peak, the values of lipid peak, area under lipidpeak and fat fraction between the different age groups of normal volunteers(p>0.05).③E xcept the values of water peak, therewere no statisticaldifference in area under water peak, the values of lipid peak, area under lipidpeak and fat fraction between male and female group of normal voluteeners(p>0.05).④In the group of≥45years, the normal volunteers and thehepaticsteatosis patients were statistical difference in area under water peak, the values of lipid peak, area under lipid peak and fat fraction but the values ofwater peak. The <45years group had the same results.⑤In the femalegroup,there were statistical difference between volunteers and patients in areaunder water peak, the values of lipid peak, area under lipid peak and fatfraction.In the male group, all the data were statistical difference except thevalues of water peak.⑥The95%confidence interval of normal liver areaunder water peak, values of lipid peak, area unfer lipid peak and fat fractionwere163.05±27.45,6.89±2.72,4.22±4.98,2.51±2.61%, respective.⑦Thethesholds of1H-MRS of values of lipid peak, area under lipid peak and fatfraction between normal liver and hepatic steatosis patients were9.55(sensitivity0.909,1-specificity0),8.65(sensitivity0.955,1-specificity0.029),4.97%(sensitivity0.955,1-specificity0.029), respective.Conclusion:3.0T1H-MRS can be used to accurately quantify normalliver and hepatic steatosis.The water and fat spectrum reference value of MRSin normal liver show important values in diagnosis of liver metabolic disease.Part23.0T MR diffusion imaging in the quantitative study of normalliverObjective: To investigate the value of DWI on the quantification ofnormal hepatic at3.0T MR united.Methods:There were38healthy volunteers in this study,including19males and19females, from25～75years old with mean age41.22±14.67.Allvolunteers were divided in different groups by age:≥45years old or <45yearsold,and by gender:male or female.38volunteers underwent DWI with3.0TMR, collected the ADC values when b values were500,800,1000s/mm~2,andthen statistical comparative analyzed all data.Results: When b values were500,800,1000s/mm~2, there were nostatistical difference between different age groups, and also in the differentgender groups(p <0.05). In the same age groups or the same gender groups,the ADC values were significant difference between b=500s/mm~2and b=800 or1000s/mm~2(p<0.05), however there were no statistical difference betweenb=800s/mm~2and b=1000s/mm~2(p>0.05). When b values were500s/mm~2,800s/mm~2and1000s/mm~2, the95%confidence interval of the normal liver's ADCvalues were:1448.75±313.31mm~2/s,1221.29±258.54mm~2/s,1153.53±218.21mm~2/s, respective.Conclusion: Quantitative normal ADC reference values range of normalliver by3.0T MR can be helpful to diagnosis of liver lesions.Part3The diagnosis value of combined with Proton MagneticResonance and DWI in cirrhosis by3.0T MRIObjective: To investigate the diagnostic value of combined with protonmagnetic resonance spectroscopy(1H-MRS) and DWI on the quantification ofnormal liver and the patients of hepatic cirrhosis by3.0T MR united and toinvestigate the mechanism of hepatic cirrhosis in level of molecular andmetabolic.Methods:38normal volunteers,including19males and19females,25～75years old, with mean age were41.22±14.67.30cases patients with hepaticcirrhosis, including22males and8females,34～65years old with mean agewere50.19±8.61. All normal volunteers and the patients of hepatic cirrhosisunderwent1H-MRS and DWI (b=500,800,1000s/mm~2) examination by3.0TMR, measured the values of water perk, area under water peak, the values oflipid peak,area under lipid peak, the fat fraction and ADCvalues(b=500,800,1000s/mm~2), and then statistical comparative analyzed alldata.Results: There were significant difference (p<0.05) in values of waterpeak, area under water peak between normal liver and hepatic cirrhosis, andthe values of water peak, area under water peak of hepatic cirrhosis groupwere lower than normal liver group. Howevere, the values of lipid peak, areaunder lipid peak and fat fraction were no significant difference (p>0.05)between the normal volunteers group and cirrhosis group. When b=500s/mm~2, there were significant difference between normal volunteers group andcirrhosis group, but there were no significant difference when b=800s/mm~2orb=1000s/mm~2.Conclusion: As a noninvasive and new examination methods,~1H-MRSand DWI can clarify the mechanism of hepatic cirrhosis in level ofmolecular,and have an important value in the diagnosis of hepatic cirrhosis.