【摘要】 目的 探讨Gd-DTPA增强对于肝脏及肝脏疾病³¹P-MRS代谢参数的影响。方法 分别对肝内良、恶性病变（分别为31例和54例）及肝硬化和正常肝脏（分别为34例和21例）进行单体素³¹P-MRS扫描。计算肝细胞内pH值（pHi）、磷酸单脂（PME）、磷酸双脂（PDE）、无机磷（Pi）、γ-ATP、β-ATP、α-ATP、PME/ATP、Pi/ATP、PME/PDE、PME/Pi、PDE/Pi、PDE/ATP和低能磷酸盐（LEP）等参数。分析Gd-DTPA增强前、后肝内病变的显示情况,以及以上代谢物参数的差异。结果 Gd-DTPA增强前在体线圈定位图像上,肝癌、转移瘤和胆管癌显示欠佳或其边界欠清者分别占该病总数的47.8%（11/23）、13.6%（3/22）和66.7%（6/9）;增强后则分别为13.0%（3/23）、4.5%（1/22）和22.2%（2/9）;增强前肝脓肿、海绵状血管瘤、局灶性结节增生及腺瘤显示欠佳或其边界欠清的分别占该病总数的11.1%（1/9）、29.4%（5/17）、80%（4/5）,增强后分别为0%（0/9）、5.9%（1/17）、0%（0/5）。在增强前和增强后,正常肝脏,肝硬化,肝脏良、恶性病变的³¹ P-MRS各代谢物参数均未见统计学差异（P>0.05）。结论Gd-DTPA增强技术可增加³¹ P-MRS定位的准确性,钆对比剂不影响肝脏及其疾病代谢物检测的准确性。更多还原

【Abstract】 Objective To probe the influence of Gd-DTPA enhancement on metabolism of liver and hepatic diseases using in vivo³¹-phosphorus magnetic resonance spectroscopy(³¹ P-MRS).Methods ³¹ P-MRS scanning of liver with a single voxel was carried out in 31 cases with benign lesions,54 cases with malignant ones,34 cases with liver cirrhosis and 21 healthy subjects,respectively.Intracellular pH value（pHi）,and some metabolic parameters including phosphomonoester（PME）,phosphodiester（PDE）,inorganic phosphate（Pi）,α-ATP,β-ATP,γ-ATP,lower energetic phosphate（LEP）,and the ratios of PME/ATP,Pi/ATP,PME/PDE,PME/Pi,PDE/Pi and PDE/ATP were calculated.The differences in display of the lesions,and in the metabolic parameters above were analyzed.Results Before the contrast-enhancement,hepatocellular carcinoma,metastasis and hepatic cholangiocarcinoma with unclear display or with undefinitive margin on position images were showed in 11,3 and 6,while those were 3,1 and 2 after enhancement.Before enhancement,the abcess,heamangioma,and FNH plus adenoma were showed in 1,5 and 4,while after enhancement those were 0,1 and 0 respectively.The metabolic parameters of liver in normal liver,cirrhosis,benign and malignant lesions of liver were not of difference statistically（P>0.05） befor and after enhancement.Conclusion Gd-DTPA enhancement may improve the accuracy of ³¹P-MRS position image,and the contrast agents do not influence on the detection accuracy of metabolic parameters of liver.更多还原