복수에 대한 MR spectroscopy에서 원인에 따른 lipid와 다른 대사물질의 peak area비교

초록

Purpose : To distinguish the proton MR spectroscopic findings between ascites of liver cirrhosis (LC), hepatocellular carcinoma (HCC), and cancer peritonitis. Materials and Methods : In vivo proton MR spectroscopy (MRS) was performed in 73 subjects with ascites associated with LC(n=26), HCC (n=22), and cancer peritonitis (n=25). All MR spectroscopic examinations were performed with a 1.5T whole-body system using localized STEAM sequence with 30 msec echo time. We evaluated the most prominent peak in the MR spectra of ascitic fluid and measured areas of lipid and metabolites peaks. Areas of water peak were measured at 4.7ppm before water suppression, and both lipid and metabolites peaks were measured at 1.3ppm at 2.0-4.0 ppm, each after water suppression. We calculated mean value of water, lipid, and metabolites and evaluated ratios of lipid to water, ratios of metabolites to water, and ratios of metabolites to lipid. Results : Mean value of lipid peak area was highest in HCC group, followed by LC and cancer peritonitis groups. In contrast, mean value of metabolites peak area was highest in cancer peritonitis, followed by HCC and LC groups. But there were no significant difference in mean value of water, lipid, metabolites, ratios of lipid to water, and ratios of metabolites to water, each other. The only ratios of metabolites to lipid were significantly higher with cancer peritonitis group than with LC group and HCC group (p<0.05). Conclusion : There were some differences in the spectral patterns of proton MRS among various causes of ascites. Proton MRS is a non-invasive effective method on evaluation of ascites and ratios of metabolites to lipid can be a good parameter to differentiation of ascitic fluid.