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山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (7): 74-77.

• 论文 • 上一篇    下一篇

31P-MR波谱对肝硬化时骨骼肌能量代谢的评估

于德新,马祥兴,李笃民,张晓明,王茜,李传福   

  1. 山东大学齐鲁医院放射科, 济南 250012
  • 收稿日期:2008-09-19 发布日期:2009-07-16
  • 通讯作者: 李传福(1945- ),男,硕士,教授,主要从事腹部疾病影像学诊断研究。
  • 作者简介:于德新(1971- ),男,博士,主治医师,主要从事肿瘤血管生成成像研究。

Musculoskeletal metabolism in patients with liver cirrhosis by  31phosphorus magnetic resonance spectroscopy at 3.0 Tesla in vivo

YU Dexin, MA Xiangxing, LI Dumin, ZHANG Xiaoming, WANG Qian, LI Chuanfu   

  1. Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2008-09-19 Published:2009-07-16

摘要:

目的探讨31PMRS技术评估肝硬化对骨骼肌代谢的影响。方法分别对35例肝硬化患者及30例正常对照组的大腿后方骨骼肌进行单体素31PMRS扫描,计算骨骼肌细胞内pH值(pHi)、磷酸单酯(PME)、磷酸双酯(PDE)、无机磷(Pi)、磷酸肌酸(PCr)、γATP、βATP、αATP、Pi/ATP、PCr/ATP、PCr/PME、PCr/PDE、PCr/Pi、PME/ATP、PME/PDE、PME/Pi、PDE/ATP、PDE/Pi等指标。分析肝硬化及其分级对骨骼肌31PMRS指标的影响。结果肝硬化组骨骼肌的PME、PCr、βATP、PME/PDE及Pcr/PDE均大于正常对照组,而PDE/ATP则相反(P<0.05)。在ChildPugh分级A、B、C级患者骨骼肌的pHi分别为7.18±0.10、7.20±0.10、7.41±0.08,具有统计学差异(P=0.041, F=4.629);PME/PDE分别为0.57±0.26、0.68±0.24、1.16±0.24,也存在明显差异(P=0.047, F=4.254),而其余代谢物指标未见统计学差异(P>0.05)。结论31PMRS可以对肝硬化患者骨骼肌的异常代谢进行无创评估,骨骼肌pHi及PME/PDE随肝硬化ChildPugh分级的增加而上升。

关键词: 肝硬化;骨骼肌;磁共振波谱成像

Abstract:

To explore the value of in vivo 31phosphorus magnetic resonance spectroscopy (31PMRS) in detection of musculoskeletal metabolism for patients with liver cirrhosis. Methods31PMRS scanning with a single voxel on thigh skeletal muscle was carried out in 31 patients with liver cirrhosis and in 30 normal cases. Intracellular pH value (pHi) and some metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), phosphocreatine (PCr), γATP, βATP, αATP, and the ratios of Pi/ATP, PCr/ATP, PCr/PME, PCr/PDE, PCr/Pi, PME/ATP, PME/PDE, PME/Pi, PDE/ATP, and PDE/Pi were calculated. Influences of liver cirrhosis and ChildPugh stage on skeletal muscle were analyzed. Results31PMRS showed an increase of PME, PCr, βATP, PME/PDE, and Pcr/PDE in liver cirrhosis patients when compared with the controls, whereas the PDE/ATP was the reverse(P<0.05).  The musculoskeletal pHi in ChildPugh stage A, B and C was 7.18±0.10, 7.20±0.10, and 7.41±0.08, respectively, and in PME/PDE was 0.57±0.26, 0.68±0.24, and 1.16±0.24 respectively, which were statistically different (P<0.05). No differences in others parameters were found (P>0.05). Conclusion31PMRS may be used to noninvasively evaluate abnormal musculoskeletal metabolism caused by liver cirrhosis, and the musculoskeletal pHi and PME/PDE increase with the ChildPugh stage.

Key words: Liver cirrhosis; Skeletal muscle; Magnetic resonance spectrum

中图分类号: 

  • R575.2
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