慢性彌漫性肝病的MR研究與臨床
發(fā)布時(shí)間：2018-08-02 21:25
【摘要】：第一部分單純性脂肪肝的磁敏感加權(quán)成像 目的：探討肝臟脂肪沉積在3.0T MRI磁敏感序列上的表現(xiàn)。 材料與方法：15例單純性脂肪肝患者和20例正常健康志愿者行3.0T MR常規(guī)腹部序列和腹部磁敏感加權(quán)成像Eswan多回波序列掃描。掃描所得Eswan圖像經(jīng)后處理工作站生成校正相位圖和融合幅度圖,觀察相位圖上脂肪肝組和正常組肝實(shí)質(zhì)的表現(xiàn),在幅度圖上測(cè)量肝實(shí)質(zhì)、鄰近椎旁肌肉及椎體的信號(hào)強(qiáng)度(Slvertebr, SImuscle),以椎旁肌肉及椎體信號(hào)為參照,分別計(jì)算肝實(shí)質(zhì)相對(duì)信號(hào)強(qiáng)度rSI1、rSI2。采用SPSS17.0統(tǒng)計(jì)軟件處理數(shù)據(jù),采用兩獨(dú)立樣本t-檢驗(yàn)比較脂肪肝組與正常組間上述諸信號(hào)強(qiáng)度均數(shù),檢驗(yàn)水準(zhǔn)為P0.05。 結(jié)果：?jiǎn)渭冃灾靖位颊逧swan幅度圖肝實(shí)質(zhì)信號(hào)減低,相位圖呈雜亂顆粒狀失相位改變,類(lèi)似鄰近椎體信號(hào)。兩組間SIliver、rSI1、rSI2鐕均數(shù)有顯著性差異；兩組間SIvertebr、SImuscle均數(shù)未見(jiàn)顯著性差異。 結(jié)論：磁敏感序列相位圖及幅度圖上肝組織的失相位和短T2*改變可能與脂肪沉積有關(guān)。 第二部分慢性彌漫性肝病患者肝鐵過(guò)載與HCC 目的：研究慢性肝病患者肝臟脂肪沉積及含鐵結(jié)節(jié)在3.0T MRI磁敏感序列上的表現(xiàn)；探討慢性肝病患者HCC與肝臟含鐵結(jié)節(jié)之間的聯(lián)系；分析肝硬化背景、年齡及性別與HCC、肝臟含鐵結(jié)節(jié)之間的關(guān)系。 材料與方法：55例慢性肝病患者(肝硬化38例,慢性肝炎17例)患者和20例正常健康志愿者行MR常規(guī)腹部序列和腹部磁敏感加權(quán)成像Eswan多回波序列掃描。掃描所得Eswan圖像經(jīng)后處理工作站處理后生成獨(dú)立的校正相位圖和融合幅度圖,觀察慢性肝病組和正常組幅度圖、相位圖肝實(shí)質(zhì)的表現(xiàn),在幅度圖上測(cè)量慢性肝病組肝實(shí)質(zhì)和鄰近椎體信號(hào)強(qiáng)度(SIliver、SIvertebr),以椎體信號(hào)為參照,計(jì)算肝實(shí)質(zhì)相對(duì)信號(hào)強(qiáng)度rSI2。采用SPSS17.0統(tǒng)計(jì)軟件處理數(shù)據(jù),各組間SIliver、rSI2均數(shù)比較采用單因素方差分析并q檢驗(yàn)及兩獨(dú)立樣本t-檢驗(yàn)；在慢性肝病患者組中,采用卡方檢驗(yàn)-Fisher精確概率法,分析HCC與年齡、含鐵結(jié)節(jié)、肝硬化背景之間的關(guān)系,分析性別與肝臟含鐵結(jié)節(jié)之間的關(guān)系；采用Mann-Whitney U秩和檢驗(yàn),對(duì)HCC(+)與(—)組間肝臟含鐵結(jié)節(jié)嚴(yán)重程度進(jìn)行比較；檢驗(yàn)水準(zhǔn)為P0.05。 結(jié)果：慢性肝病組脂肪沉積和含鐵沉積分為四種改變：a.僅有肝臟脂肪變性；b.肝臟脂肪變性并含鐵結(jié)節(jié)沉積；c.僅有肝臟含鐵結(jié)節(jié)；d.脂肪變性及肝臟含鐵結(jié)節(jié)均無(wú)；在P=0.05水準(zhǔn)下,a與b、 c與d分別為相同子集,兩子集間兩種肝臟信號(hào)強(qiáng)度均數(shù)有顯著性差異,a、b及Part1單純性脂肪組間肝臟信號(hào)強(qiáng)度均數(shù)無(wú)顯著性差異。HCC的發(fā)生率在含鐵結(jié)節(jié)組間有顯著性差異;絕經(jīng)前后肝臟含鐵結(jié)節(jié)發(fā)生率有顯著性差異。肝硬化背景、年齡較大、肝臟含鐵結(jié)節(jié)嚴(yán)重程度在HCC組間無(wú)顯著性差異； 結(jié)論：腹部Eswan序列對(duì)肝臟含鐵結(jié)節(jié)顯示良好；慢性肝病肝臟脂肪變性與含鐵結(jié)節(jié)可以并存,含鐵結(jié)節(jié)不一定導(dǎo)致背景肝組織的短T2*效應(yīng)；肝臟含鐵結(jié)節(jié)與HCC的發(fā)生有顯著聯(lián)系；雌激素與HCC、含鐵結(jié)節(jié)的形成有顯著關(guān)聯(lián)；肝硬化背景及年齡較大與HCC的發(fā)生無(wú)顯著關(guān)聯(lián)。 第三部分慢性彌漫性肝病在體肝臟質(zhì)子波譜初探 目的：研究慢性肝病患者肝臟3.0T質(zhì)子波譜1H-MRS的表現(xiàn),探討膽堿復(fù)合物峰(CCC)與血清生化指標(biāo)及肝臟貯備功能之間的聯(lián)系。 材料與方法：33例慢性肝病患者(肝硬化22例,慢性肝炎11例)和10例正常健康志愿者行肝臟1H MRS掃描。使用Sage軟件對(duì)所得肝臟譜線進(jìn)行后處理,觀察正常組與慢性肝病組肝臟波譜表現(xiàn),以肝組織水峰為內(nèi)標(biāo),計(jì)算CCC峰與水峰的比值。采用SPSS17.0統(tǒng)計(jì)分析軟件處理數(shù)據(jù),在慢性肝病患者中,采用卡方檢驗(yàn)-Fisher精確概率法,比較高大CCC組與微小或無(wú)CCC峰組間血清轉(zhuǎn)氨酶、直接膽紅素的差異；采用Mann-Whitney U秩和檢驗(yàn),比較兩組間血清白蛋白計(jì)分和肝臟Child-Pugh分級(jí)的分布差異：檢驗(yàn)水準(zhǔn)均為P0.05。 結(jié)果：正常組肝臟1H-MRS未見(jiàn)CCC峰；慢性肝病組24例可見(jiàn)CCC峰,14例表現(xiàn)為高大CCC峰,CCC/水峰比值的均數(shù)0.371±0.066；10例為微小CCC峰,CCC/水峰的比值均數(shù)0.070±0.016。慢性肝病組5例未見(jiàn)CCC峰,4例患者譜線不合格。組間血清膽紅素、Child-Pugh分級(jí)有顯著性差異,組間白蛋白計(jì)分、血清轉(zhuǎn)氨酶無(wú)顯著性差異。 結(jié)論：慢性肝病患者高大CCC峰與肝內(nèi)膽汁淤積有顯著關(guān)聯(lián),膽汁淤積時(shí)膽汁成分、脂肪代謝異常、肝細(xì)胞的有絲分裂可能導(dǎo)致了CCC峰的升高。 第四部分磁敏感加權(quán)成像評(píng)價(jià)肝硬化脾臟含鐵結(jié)節(jié) 目的：運(yùn)用腹部磁敏感序列Eswan,探討肝硬化患者脾臟含鐵結(jié)節(jié)的發(fā)生率及其與脾亢、脾臟增大、門(mén)靜脈側(cè)枝靜脈曲張及肝臟貯備功能分級(jí)之間的聯(lián)系。 材料與方法：4l例肝硬化患者和20例正常健康志愿者行MR常規(guī)腹部序列和腹部磁敏感加權(quán)成像Eswan多回波序列掃描。掃描所得Eswan圖像經(jīng)后處理工作站處理后生成獨(dú)立的校正相位圖和融合幅度圖。測(cè)量肝硬化患者脾臟容積,對(duì)脾臟容積及Eswan幅度圖上脾臟含鐵結(jié)節(jié)數(shù)量進(jìn)行分度和分級(jí)。采用SPSS17.0統(tǒng)計(jì)分析軟件處理數(shù)據(jù),采用獨(dú)立樣本t-檢驗(yàn)比較脾亢組間、脾臟含鐵結(jié)節(jié)組間脾臟容積的均數(shù)；采用Mann-Whitney U秩和檢驗(yàn)比較脾亢組間脾臟容積增大程度、脾內(nèi)含鐵結(jié)節(jié)數(shù)量的分布及脾臟含鐵結(jié)節(jié)組Child-Pugh分級(jí)和側(cè)枝靜脈曲張的形成情況；采用Spearman-rho相關(guān)分析,分析脾臟容積與脾臟含鐵結(jié)節(jié)數(shù)量間的相關(guān)性；檢驗(yàn)水準(zhǔn)為P0.05。 結(jié)果：Eswan序列肝硬化患者脾臟含鐵結(jié)節(jié)發(fā)生率為78%；脾臟容積在脾亢組間、脾臟含鐵結(jié)節(jié)組間均有顯著性差異,脾臟容積與含鐵結(jié)節(jié)數(shù)量間有顯著性正相關(guān)；脾臟含鐵結(jié)節(jié)組間Child-Pugh分級(jí)有顯著差異；側(cè)枝循環(huán)組間脾臟含鐵結(jié)節(jié)嚴(yán)重程度的分布有顯著差異。 結(jié)論：腹部Eswan序列檢測(cè)脾臟含鐵結(jié)節(jié)明顯優(yōu)于其他序列；肝硬化脾臟含鐵結(jié)節(jié)與血小板減少、脾臟增大、肝臟貯備功能分級(jí)均有顯著聯(lián)系；重度脾臟增大和脾臟彌漫多發(fā)含鐵結(jié)節(jié)(Eswan2級(jí)圖像)能可靠的反映脾臟功能亢進(jìn)；脾臟含鐵結(jié)節(jié)與側(cè)枝靜脈曲張有顯著關(guān)聯(lián),出現(xiàn)脾臟彌漫多發(fā)含鐵結(jié)節(jié)時(shí),要警惕側(cè)枝靜脈曲張出血事件的發(fā)生。
[Abstract]:The first part is susceptibility weighted imaging of simple fatty liver.
Objective: To investigate the expression of hepatic fat deposition on 3.0T MRI magnetic susceptibility sequence.
Materials and methods: 15 cases of simple fatty liver and 20 normal healthy volunteers were performed 3.0T MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scanning. The Eswan images were generated by the postprocessing workstation to generate the corrected phase map and the fusion amplitude map, and to observe the fatty liver group and the normal liver parenchyma on the phase map. The liver parenchyma, adjacent muscle and vertebral signal intensity (Slvertebr, SImuscle) were measured on the amplitude map, and the relative signal intensity rSI1 of the liver parenchyma was calculated with the paravertebral muscles and vertebral signals as reference. The data were processed by SPSS17.0 statistical software, and the two independent samples t- test was used to compare the above results between the fatty liver group and the normal group. The signal intensity is all, the test level is P0.05.
Results: the hepatic parenchyma signal of Eswan amplitude was decreased in the patients with simple fatty liver, and the phase diagram showed a random granular phase change, similar to the adjacent vertebral signal. There were significant differences in the number of SIliver, rSI1 and rSI2 between the two groups; there was no significant difference in the number of SIvertebr and SImuscle among the two groups.
Conclusion: the change of phase and short T2* of hepatic tissue phase and amplitude map may be related to fat deposition.
The second part is iron overload and HCC in patients with chronic diffuse liver disease.
Objective: To investigate the expression of liver fat deposition and iron bearing nodules on 3.0T MRI magnetic sensitive sequence in patients with chronic liver disease, and to explore the relationship between HCC and iron nodules in the liver of patients with chronic liver disease, and to analyze the relationship between liver cirrhosis background, age and sex with HCC, and liver iron bearing nodules.
Materials and methods: 55 patients with chronic liver disease (38 cases of liver cirrhosis, 17 cases of chronic hepatitis) and 20 normal healthy volunteers were performed MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scanning. The Eswan images were processed by the post processing workstation to generate an independent correction phase map and a fusion amplitude map. The amplitude map of the chronic liver disease group and the normal group, the manifestation of the liver parenchyma, the amplitude of the liver parenchyma and the adjacent vertebral signal intensity (SIliver, SIvertebr) were measured on the amplitude graph, and the relative signal intensity of the liver parenchyma was calculated by the SPSS17.0 statistical software with the reference of the vertebral signal, and the number of SIliver and rSI2 in each group was compared. Single factor ANOVA, q test and two independent sample t- test; in patients with chronic liver disease, chi square test -Fisher accurate probability method was used to analyze the relationship between HCC and age, iron bearing nodules, liver cirrhosis background, analysis of the relationship between sex and liver iron nodules; Mann-Whitney U rank sum test, between HCC (+) and (-) groups The severity of liver iron nodules was compared; the inspection level was P0.05.
Results: there were four changes in fat deposition and iron inclusion integration in chronic liver disease group: A. only liver fatty degeneration, B. liver fatty degeneration and iron nodule deposit; C. only liver containing iron nodules; D. fatty degeneration and liver iron nodules were not; at P=0.05 level, a and B, C and D were the same subsets, and two kinds of liver letters between the two subsets. There was significant difference in the number of intensity. There was no significant difference in the liver signal intensity between a, B and Part1. The incidence of.HCC was significantly different between the iron nodules group. The incidence of iron nodules in the liver before and after menopause was significantly different. The liver cirrhosis background, the older age, and the severity of liver bearing iron nodules were not significant in the HCC group. Sexual differences;
Conclusion: the abdominal Eswan sequence is good for the iron bearing nodules of the liver; liver fatty degeneration and iron nodules can coexist in chronic liver disease, and iron nodules do not necessarily lead to the short T2* effect of the background liver tissue; the iron nodules in the liver have a significant relationship with the occurrence of HCC; estrogen has a significant association with the formation of HCC and iron bearing nodules; the liver cirrhosis is on the back of the liver. There was no significant correlation between the age and the age of HCC.
The third part is the proton spectroscopy of liver in chronic diffuse liver disease.
Objective: To study the expression of 3.0T proton spectrum 1H-MRS in the liver of patients with chronic liver disease, and to explore the relationship between the choline complex peak (CCC) and serum biochemical indexes and liver reserve function.
Materials and methods: liver 1H MRS scan was performed in 33 patients with chronic liver disease (22 liver cirrhosis, 11 chronic hepatitis) and 10 normal healthy volunteers. The liver spectral lines of the normal and chronic liver disease groups were treated by Sage software, and the liver tissue water peak was used as the internal standard to calculate the ratio of the CCC peak to the water peak. The SPS was used to calculate the ratio of the peak of the liver to the water peak. S17.0 statistical analysis software processing data, in chronic liver disease patients, using chi square test -Fisher accurate probability method, compare the difference of serum transaminase and direct bilirubin between the large CCC group and the small or no CCC peak group, and compare the distribution difference of serum albumin score and liver Child-Pugh classification between the two groups using Mann-Whitney U rank sum test. The test level is P0.05.
Results: there was no CCC peak in normal liver 1H-MRS, 24 cases of chronic liver disease showed CCC peak, 14 cases were high CCC peak, CCC/ water peak ratio was 0.371 + 0.066, 10 cases were small CCC peak, the ratio of CCC/ water peak was 0.070 + 0.016. chronic liver disease group 5 cases did not see CCC peak, 4 patients were disqualified. Serum bilirubin, Child-Pugh points between the group. There was significant difference between the two groups. Albumin score and serum aminotransferase were not significantly different between the two groups.
Conclusion: there is a significant association between high CCC peak and intrahepatic cholestasis in patients with chronic liver disease. Bile composition and lipid metabolism are abnormal in cholestasis, and the mitosis of liver cells may lead to the increase of CCC peak.
The fourth part is susceptibility weighted imaging to evaluate the splenic iron nodules in liver cirrhosis.
Objective: To investigate the incidence of iron bearing nodules in the liver of patients with liver cirrhosis and the association between the incidence of iron bearing nodules in the patients with liver cirrhosis and its relationship with the hypersplenism, the splenomegaly, the varicose veins of the portal vein and the grading of the liver function by using the abdominal magnetic sensitive sequence Eswan.
Materials and methods: 4L patients with liver cirrhosis and 20 normal healthy volunteers were performed MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scan. The Eswan images were processed by the post-processing workstation to generate an independent correction phase map and a fusion amplitude map. The spleen volume and spleen volume were measured in patients with liver cirrhosis. The number of the spleen containing iron nodules on the Eswan amplitude map was divided and graded. The data were processed by the SPSS17.0 statistical analysis software. The splenic volume was compared between the hypersplenism group and the splenic iron nodule group by the independent sample t- test. The degree of splenomegaly between the hypersplenism group was compared with the Mann-Whitney U rank test. The iron nodules in the spleen were compared. The distribution of the quantity and the formation of Child-Pugh grade and lateral branch varicosity in the iron bearing group of the spleen; the correlation between the spleen volume and the number of the spleen containing iron nodules was analyzed by Spearman-rho correlation analysis; the test level was P0.05.
Results: the incidence of iron nodules in the spleen of the patients with Eswan sequence was 78%, the spleen volume was between the splenomegaly group and the iron nodule group, the spleen volume was significantly correlated with the number of iron nodules, and the Child-Pugh classification between the splenic iron nodules group was significantly different, and the iron nodules between the splenic circulation groups were with iron nodules. There were significant differences in the distribution of severity.
Conclusion: the abdominal Eswan sequence is superior to the other sequences in detecting the iron bearing nodules of the spleen. The iron nodules of the liver cirrhosis and the thrombocytopenia, the enlargement of the spleen and the classification of the liver reserve function have significant relation. The severe spleen enlargement and the spleen diffuse multiple iron bearing nodules (Eswan2 grade images) can reliably reflect the hyperfunction of the spleen; the spleen contains the spleen. Iron nodules are significantly associated with varicose collateral veins. When multiple iron nodules appear in the spleen, it is necessary to be alert to the occurrence of hemorrhage from varicose collateral veins.
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R575.2
本文編號(hào)：2160780
[Abstract]:The first part is susceptibility weighted imaging of simple fatty liver.
Objective: To investigate the expression of hepatic fat deposition on 3.0T MRI magnetic susceptibility sequence.
Materials and methods: 15 cases of simple fatty liver and 20 normal healthy volunteers were performed 3.0T MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scanning. The Eswan images were generated by the postprocessing workstation to generate the corrected phase map and the fusion amplitude map, and to observe the fatty liver group and the normal liver parenchyma on the phase map. The liver parenchyma, adjacent muscle and vertebral signal intensity (Slvertebr, SImuscle) were measured on the amplitude map, and the relative signal intensity rSI1 of the liver parenchyma was calculated with the paravertebral muscles and vertebral signals as reference. The data were processed by SPSS17.0 statistical software, and the two independent samples t- test was used to compare the above results between the fatty liver group and the normal group. The signal intensity is all, the test level is P0.05.
Results: the hepatic parenchyma signal of Eswan amplitude was decreased in the patients with simple fatty liver, and the phase diagram showed a random granular phase change, similar to the adjacent vertebral signal. There were significant differences in the number of SIliver, rSI1 and rSI2 between the two groups; there was no significant difference in the number of SIvertebr and SImuscle among the two groups.
Conclusion: the change of phase and short T2* of hepatic tissue phase and amplitude map may be related to fat deposition.
The second part is iron overload and HCC in patients with chronic diffuse liver disease.
Objective: To investigate the expression of liver fat deposition and iron bearing nodules on 3.0T MRI magnetic sensitive sequence in patients with chronic liver disease, and to explore the relationship between HCC and iron nodules in the liver of patients with chronic liver disease, and to analyze the relationship between liver cirrhosis background, age and sex with HCC, and liver iron bearing nodules.
Materials and methods: 55 patients with chronic liver disease (38 cases of liver cirrhosis, 17 cases of chronic hepatitis) and 20 normal healthy volunteers were performed MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scanning. The Eswan images were processed by the post processing workstation to generate an independent correction phase map and a fusion amplitude map. The amplitude map of the chronic liver disease group and the normal group, the manifestation of the liver parenchyma, the amplitude of the liver parenchyma and the adjacent vertebral signal intensity (SIliver, SIvertebr) were measured on the amplitude graph, and the relative signal intensity of the liver parenchyma was calculated by the SPSS17.0 statistical software with the reference of the vertebral signal, and the number of SIliver and rSI2 in each group was compared. Single factor ANOVA, q test and two independent sample t- test; in patients with chronic liver disease, chi square test -Fisher accurate probability method was used to analyze the relationship between HCC and age, iron bearing nodules, liver cirrhosis background, analysis of the relationship between sex and liver iron nodules; Mann-Whitney U rank sum test, between HCC (+) and (-) groups The severity of liver iron nodules was compared; the inspection level was P0.05.
Results: there were four changes in fat deposition and iron inclusion integration in chronic liver disease group: A. only liver fatty degeneration, B. liver fatty degeneration and iron nodule deposit; C. only liver containing iron nodules; D. fatty degeneration and liver iron nodules were not; at P=0.05 level, a and B, C and D were the same subsets, and two kinds of liver letters between the two subsets. There was significant difference in the number of intensity. There was no significant difference in the liver signal intensity between a, B and Part1. The incidence of.HCC was significantly different between the iron nodules group. The incidence of iron nodules in the liver before and after menopause was significantly different. The liver cirrhosis background, the older age, and the severity of liver bearing iron nodules were not significant in the HCC group. Sexual differences;
Conclusion: the abdominal Eswan sequence is good for the iron bearing nodules of the liver; liver fatty degeneration and iron nodules can coexist in chronic liver disease, and iron nodules do not necessarily lead to the short T2* effect of the background liver tissue; the iron nodules in the liver have a significant relationship with the occurrence of HCC; estrogen has a significant association with the formation of HCC and iron bearing nodules; the liver cirrhosis is on the back of the liver. There was no significant correlation between the age and the age of HCC.
The third part is the proton spectroscopy of liver in chronic diffuse liver disease.
Objective: To study the expression of 3.0T proton spectrum 1H-MRS in the liver of patients with chronic liver disease, and to explore the relationship between the choline complex peak (CCC) and serum biochemical indexes and liver reserve function.
Materials and methods: liver 1H MRS scan was performed in 33 patients with chronic liver disease (22 liver cirrhosis, 11 chronic hepatitis) and 10 normal healthy volunteers. The liver spectral lines of the normal and chronic liver disease groups were treated by Sage software, and the liver tissue water peak was used as the internal standard to calculate the ratio of the CCC peak to the water peak. The SPS was used to calculate the ratio of the peak of the liver to the water peak. S17.0 statistical analysis software processing data, in chronic liver disease patients, using chi square test -Fisher accurate probability method, compare the difference of serum transaminase and direct bilirubin between the large CCC group and the small or no CCC peak group, and compare the distribution difference of serum albumin score and liver Child-Pugh classification between the two groups using Mann-Whitney U rank sum test. The test level is P0.05.
Results: there was no CCC peak in normal liver 1H-MRS, 24 cases of chronic liver disease showed CCC peak, 14 cases were high CCC peak, CCC/ water peak ratio was 0.371 + 0.066, 10 cases were small CCC peak, the ratio of CCC/ water peak was 0.070 + 0.016. chronic liver disease group 5 cases did not see CCC peak, 4 patients were disqualified. Serum bilirubin, Child-Pugh points between the group. There was significant difference between the two groups. Albumin score and serum aminotransferase were not significantly different between the two groups.
Conclusion: there is a significant association between high CCC peak and intrahepatic cholestasis in patients with chronic liver disease. Bile composition and lipid metabolism are abnormal in cholestasis, and the mitosis of liver cells may lead to the increase of CCC peak.
The fourth part is susceptibility weighted imaging to evaluate the splenic iron nodules in liver cirrhosis.
Objective: To investigate the incidence of iron bearing nodules in the liver of patients with liver cirrhosis and the association between the incidence of iron bearing nodules in the patients with liver cirrhosis and its relationship with the hypersplenism, the splenomegaly, the varicose veins of the portal vein and the grading of the liver function by using the abdominal magnetic sensitive sequence Eswan.
Materials and methods: 4L patients with liver cirrhosis and 20 normal healthy volunteers were performed MR routine abdominal sequence and abdominal magnetic sensitive weighted imaging Eswan multiple echo sequence scan. The Eswan images were processed by the post-processing workstation to generate an independent correction phase map and a fusion amplitude map. The spleen volume and spleen volume were measured in patients with liver cirrhosis. The number of the spleen containing iron nodules on the Eswan amplitude map was divided and graded. The data were processed by the SPSS17.0 statistical analysis software. The splenic volume was compared between the hypersplenism group and the splenic iron nodule group by the independent sample t- test. The degree of splenomegaly between the hypersplenism group was compared with the Mann-Whitney U rank test. The iron nodules in the spleen were compared. The distribution of the quantity and the formation of Child-Pugh grade and lateral branch varicosity in the iron bearing group of the spleen; the correlation between the spleen volume and the number of the spleen containing iron nodules was analyzed by Spearman-rho correlation analysis; the test level was P0.05.
Results: the incidence of iron nodules in the spleen of the patients with Eswan sequence was 78%, the spleen volume was between the splenomegaly group and the iron nodule group, the spleen volume was significantly correlated with the number of iron nodules, and the Child-Pugh classification between the splenic iron nodules group was significantly different, and the iron nodules between the splenic circulation groups were with iron nodules. There were significant differences in the distribution of severity.
Conclusion: the abdominal Eswan sequence is superior to the other sequences in detecting the iron bearing nodules of the spleen. The iron nodules of the liver cirrhosis and the thrombocytopenia, the enlargement of the spleen and the classification of the liver reserve function have significant relation. The severe spleen enlargement and the spleen diffuse multiple iron bearing nodules (Eswan2 grade images) can reliably reflect the hyperfunction of the spleen; the spleen contains the spleen. Iron nodules are significantly associated with varicose collateral veins. When multiple iron nodules appear in the spleen, it is necessary to be alert to the occurrence of hemorrhage from varicose collateral veins.
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R575.2
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相關(guān)期刊論文 前8條
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