CAJ | 학술논문

目的:通过对白血病肝脏浸润(LIL)病例与正常对照组的肝脏二维化学位移磁共振31磷波谱成像(2D CSI ~(31)P MRS)对照研究,探讨LIL的肝脏磷化合物代谢特征变化.方法:收集LIL 15例,并与12例正常肝脏作对照,进行2D CSI ~(31)P MRS肝脏扫描,检测各种磷代谢物包括磷酸单酯(PME)、磷酸双酯(PDE)、三磷酸腺苷(ATP)、无机磷(Pi)的相对值,经体模所测校正系数校正后,分析PME、PDE、Pi、ATP的校正相对值(以下简称相对值),及PME/PDE、PME/ATP、PDE/ATP、Pi/ATP、 PME/(PME+PDE)的比值变化.结果:在所测的肝脏磷代谢物相对值中,仅LIL组的PME相对值升高,为1.992±0.876,与对照组(1.167±0.427)相比有显著性差异,P<0.05;其它各磷代谢物相对值均无差异.比较LIL与正常对照组之间磷代谢物比值,发现LIL组中与PME相关的比值包括PME/PDE、PME/ATP和PME/(PME+PDE)比值升高,分别为0.551±0.339、1.402±0.654和0.326±0.13,与对照组(分别为0.254±0.059、0.792±0.232和0.199±0.049)相比有显著性差异,P<0.01;LIL组的其它磷代谢物比值与对照组相比均无显著差异.结论:肝~(31)P MRS检查为LIL提供新的非创伤性检测和评价方法,肝脏PME相对值及其相应比值升高提示白血病患者肝浸润存在的可能.
목적:통과대백혈병간장침윤(LIL)병례여정상대조조적간장이유화학위이자공진31린파보성상(2D CSI ~(31)P MRS)대조연구,탐토LIL적간장린화합물대사특정변화.방법:수집LIL 15례,병여12례정상간장작대조,진행2D CSI ~(31)P MRS간장소묘,검측각충린대사물포괄린산단지(PME)、린산쌍지(PDE)、삼린산선감(ATP)、무궤린(Pi)적상대치,경체모소측교정계수교정후,분석PME、PDE、Pi、ATP적교정상대치(이하간칭상대치),급PME/PDE、PME/ATP、PDE/ATP、Pi/ATP、 PME/(PME+PDE)적비치변화.결과:재소측적간장린대사물상대치중,부LIL조적PME상대치승고,위1.992±0.876,여대조조(1.167±0.427)상비유현저성차이,P<0.05;기타각린대사물상대치균무차이.비교LIL여정상대조조지간린대사물비치,발현LIL조중여PME상관적비치포괄PME/PDE、PME/ATP화PME/(PME+PDE)비치승고,분별위0.551±0.339、1.402±0.654화0.326±0.13,여대조조(분별위0.254±0.059、0.792±0.232화0.199±0.049)상비유현저성차이,P<0.01;LIL조적기타린대사물비치여대조조상비균무현저차이.결론:간~(31)P MRS검사위LIL제공신적비창상성검측화평개방법,간장PME상대치급기상응비치승고제시백혈병환자간침윤존재적가능.
Objective: To evaluate the changes of phosphorus metabolites in leukemic infiltration of liver (LIL) with two-dimensional chemical shift imaging(2D CSI) ~(31)Phosphorus MR spectroscopy (~(31)P MRS). Methods: Fifteen patients with LIL and 12 healthy subjects (control group) were scanned with liver 2D CSI ~(31)P MRS by a 1.5T MR Scanner (Sonata,Siemens Corporation).Relative quantification of phosphorus metabolites including phosphomonoesters (PME),inorganic phosphate (Pi),phosphodiesters (PDE) and β-adenosine- triphosphate (β-ATP) were detected and after calibrated with model factor,the ratios of PME/PDE,PME/(PME+PDE),PME/ATP,PDE/ATP and Pi/ATP were analyzed. Results: Compared with control group,the PME value,PME/PDE ratio,PME/(PME+PDE) ratio and PME/ATP ratio were increased in LIL group (1.992±0.876 vs 1.167±0.427,P<0.05),(0.551±0.339 vs 0.254±0.059,P<0.01), (0.326±0.13 vs 0.199±0.049,P<0.01)and (1.402±0.654 vs 0.792±0.232,P<0.01) respectively. Conclusion: ~(31)P MRS examination can be used as a non-invasive procedure to evaluate the changes of phosphorus metabolites of leukemic infiltration of liver.The increase of PME value and its ratios to PDE,ATP and PME+PDE may indicate leukemic infiltration of liver.