摘要
目的通过动物模型评价氢质子磁共振波谱(1H-MRS)在肝纤维化诊断中的应用价值。方法对以四氯化碳诱导产生的肝纤维化模型兔和对照组兔行1H-MRS检查,获得肝脏主要含氢代谢物的波峰下面积,包括脂质(lipid)、胆碱(Cho)、糖原/葡萄糖复合物(Glyu),同时计算代谢物与脂质的波峰下面积比值(Cho/lipid、Glyu/lipid)。以病理学肝纤维化分期为基础将兔划分为无纤维化组(S0)、轻中度纤维化组(S1～S2)和重度纤维化/肝硬化组(S3～S4),比较不同组间1H-MRS参数变化情况,同时观察透射电镜下肝脏超微结构的变化。结果Cho、Glyu和lipid在轻中度纤维化组降低,在重度纤维化/肝硬化组升高;Cho/lipid和Glyu/lipid随肝纤维化的加重而升高。重度纤维化/肝硬化组与另两组Cho/lipid比较,差异有统计学意义(P均<0.05),其余指标在纤维化各组间差异无统计学意义。肝组织超微结构改变在轻中度纤维化时以肝细胞损伤为主,在重度纤维化/肝硬化时肝细胞损伤与细胞外纤维基质沉积并重。结论肝纤维化时肝细胞损伤引起代谢物减少,细胞外基质沉积阻碍代谢物排出,1H-MRS变化是对肝组织超微结构改变的综合反映。Cho/lipid是检测重度纤维化/肝硬化的有效指标。
Objective To evaluate proton magnetic resonance spectroscopy （^1 H-MRS） in the diagnosis of liver fibrosis in rabbits. Methods Rabbits with liver fibrosis induced by carbon tetrachloride and controls were examined with ^1H-MRS. According to histological fibrosis stage, the rabbits were divided into three groups： No fibrosis （SO）, mild/moderate fibrosis （S1-S2）, and severe fibrosis/cirrhosis （S3-S4）. The peak areas of lipid, choline （Cho）, glycogen and glucose complex （Glyu） as well as the ratios of Cho/lipid, Glyu/lipid were calculated and compared among groups of liver fibrosis. The ultra- structural changes of the liver were observed with transmission electronic microscope. Results Cho, Glyu, lipid decreased in mild/moderate fibrosis and increased in severe fibrosis/cirrhosis, while Cho/lipid and Glyu/lipid increased gradually as the severity of fibrosis progressed. Of all parameters, only Cho/lipid was statistically different between severe fibrosis/cirrhosis and the other groups of fibrosis （P〈0.05）. On electron microscopy, the main abnormalities in mild/moderate fibrosis were hepatocyte injury, while in severe fibrosis and cirrhosis, both hepatocyte injury and extracellular matrix deposition were prominent. Conclusion Destroyed hepatocytes result in reduction of intracellular metabolites, while excellular matrix accumulation disturbs excretion of metabolites. The spectral abnormalities of 1 H-MRS in liver fibrosis are consistent with ultra- structural alterations. Cho/lipid is an effective marker for detecting severe fibrosis/cirrhosis.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第5期789-792,共4页
Chinese Journal of Medical Imaging Technology
基金
广东省医学科研基金课题(A2009026)
关键词
肝硬化
磁共振波谱
显微镜检查
电子
动物实验
Liver cirrhosis
Magnetic resonance spectroscopy
Microscopy, electron
Animals, experimentation
作者简介
王秋实（1974-），女，辽宁鞍山人，博士，副主任医师。研究方向：腹部影像诊断。E-mail：wangqscmu@gmail．com
[通讯作者]梁长虹，广东省人民医院放射科广东省医学科学院，510080。E—mail：dr_liang62@hotmail．com
