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目的探讨31P磁共振波谱成像(MRS)在肝脏良、恶性占位性病变诊断中的价值。方法分别对35个(其中肝脓肿13个)肝脏良性病灶及62个恶性病灶进行单体素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-、β-、及α-三磷酸腺苷(ATP)、PME/ATP、Pi/ATP、PME/PDE、PME/Pi、PDE/Pi、PDE/ATP和低能磷酸盐(LEP)等参数。分析以上代谢参数在良、恶性病变之间差异。结果在良、恶性病变之间,γ-ATP分别为1 279.46±432.21和758.22±240.79,Pi/ATP分别为3.98±0.86和5.36±0.96,差异均有统计学意义(P<0.05);在良、恶性肿瘤及肝脓肿之间,pHi分别为7.03±0.43、7.09±0.35、7.45±0.51,γ-ATP分别为1 260.71±407.72、758.22±240.79、1 268.62±444.10,差异均有统计学意义(P<0.05),其余代谢物参数在以上各种分组之间差异无统计学意义(P>0.05)。结论31P-MRS代谢物γ-ATP和Pi/ATP可作为鉴别肝脏良、恶性病变的参数,pHi值有助于肝脓肿与肝脏肿瘤的鉴别。
Objective To investigate the value of 31 P magnetic resonance spectroscopy (MRS) in the diagnosis of benign and malignant liver lesions. Methods Thirty-five liver biopsies (including liver abscesses) and 62 malignant lesions were examined by single-element 31P-MRS. The intracellular pH value, phospholipid monoester (PME), phospholipid PDE, PME / PDE, PME / Pi, PDE / Pi, PDE / ATP and low energy phosphate (LEP) and other parameters. Analysis of metabolic parameters in the difference between benign and malignant lesions. Results The results showed that γ-ATP was 1 279.46 ± 432.21 and 758.22 ± 240.79 respectively in benign and malignant lesions, and the differences were statistically significant (P <0.05) for Pi / ATP and 3.98 ± 0.86 and 5.36 ± 0.96, respectively , Malignant tumors and liver abscess, the pHi were 7.03 ± 0.43, 7.09 ± 0.35 and 7.45 ± 0.51 respectively, and the values of γ-ATP were 1 260.71 ± 407.72, 758.22 ± 240.79 and 1 268.62 ± 444.10, respectively P <0.05). There was no significant difference in the other metabolites between the above groups (P> 0.05). Conclusion The 31P-MRS metabolites γ-ATP and Pi / ATP can be used as parameters in differentiating benign and malignant liver diseases. PHi value is helpful to differentiate liver abscess from liver tumor.