복수의 수소자기공명분광 소견: 지질과 대사물의 면적 비율

초록

Purpose: To distinguish the 1H MR spectroscopic findings between ascites of liver cirrhosis (LC), hepatocellular carcinoma (HCC), and cancer peritonitis. Material and methods: In vivo 1H 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 spectrums of ascitic fluid and measured areas of lipid and metabolites peaks. Areas of water peak were measured at 4.7 ppm before water suppression, and both lipid and metabolites peaks were measured at 1.3 ppm at 2.0-4.0 ppm, each after water suppression. Peak area ratios of the lipid and metabolites were calculated. Results : Lipid peak at 1.3ppm was noted as prominent peak in 13 LC cases (50%), 14 HCC cases (64%) and 11 cancer peritonitis cases (44%). A LC and a cancer peritonitis cases showed prominent peak at 5.5ppm. 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. The peak area ratios of metabolites to lipid were significantly higher with cancer peritonitis group (2.7&#61617;1.9) than with LC group (1.8&#61617;1.3) and HCC group (1.5&#61617;1.1 ) (P < .05). Conclusion: There were some differences in the spectral patterns of 1H MRS among various causes of ascites, and the spectral differences might be the basic data for differentiation of the ascites as a non-invasive diagnostic method of 1H MRS.