CAJ | 학술논문

目的利用ROC曲线比较生化、超声、CT、质子磁共振波谱(1H MRS)定量诊断脂肪肝的应用价值.方法选用45只健康新西兰大白兔,高脂高糖饲料加酒精饮料建立不同程度脂肪肝模型,应用生化、超声、CT及1H MRS多种.临床诊断方法,共观测18个变量指标,在每种诊断方法所观测的指标中,选取与脂肪肝分级相关性最高的指标,并以此进行受试者操作特征(ROC)曲线分析和ROC曲线下面积Z检验,比较这几种诊断方法的应用价值.结果在所有18个观测指标中,血清胆固醇、超声衰减系数、肝CT值和1H MRS脂肪波峰下面积分别是生化、超声、CT、1H MRS诊断方法中与脂肪肝分级相关性最高的观测指标,相关系数分别为0.886(P=0.000)、0.483(P=0.002)、-0.764(P=0.000)、0.558(P=0.001);ROC曲线分析和Z检验显示:上述各指标ROC曲线下面积分别为0.981,0.581,0.810,0.713,除1H MRS脂肪波峰下面积与超声衰减系数、肝CT值之间差异无统计学意义外(P>O.05),其他两两之间差异均有统计学意义(P<O.05).结论在脂肪肝的定量诊断中,几种影像学方法的应用价值由高到低依次为:CT>1H MRS>超声;生化测定血清胆固醇水平对判断脂肪肝程度可能具有重要的意义,值得进一步研究.
목적 이용ROC곡선비교생화、초성、CT、질자자공진파보(1H MRS)정량진단지방간적응용개치.방법 선용45지건강신서란대백토,고지고당사료가주정음료건립불동정도지방간모형,응용생화、초성、CT급1H MRS다충.림상진단방법,공관측18개변량지표,재매충진단방법소관측적지표중,선취여지방간분급상관성최고적지표,병이차진행수시자조작특정(ROC)곡선분석화ROC곡선하면적Z검험,비교저궤충진단방법적응용개치.결과 재소유18개관측지표중,혈청담고순、초성쇠감계수、간CT치화1H MRS지방파봉하면적분별시생화、초성、CT、1H MRS진단방법중여지방간분급상관성최고적관측지표,상관계수분별위0.886(P=0.000)、0.483(P=0.002)、-0.764(P=0.000)、0.558(P=0.001);ROC곡선분석화Z검험현시:상술각지표ROC곡선하면적분별위0.981,0.581,0.810,0.713,제1H MRS지방파봉하면적여초성쇠감계수、간CT치지간차이무통계학의의외(P>O.05),기타량량지간차이균유통계학의의(P<O.05).결론 재지방간적정량진단중,궤충영상학방법적응용개치유고도저의차위:CT>1H MRS>초성;생화측정혈청담고순수평대판단지방간정도가능구유중요적의의,치득진일보연구.
Objective To compare the values of biochemistry, ultrasonography ( US) , computed tomography(CT) and proton magnetic resonance spectroscopy ('H MRS) in the quantitative diagnosis of fatty liver. Methods Forty-five healthy New Zealand rabbits were enrolled in the study. Hepatic steatosis models were established by giving high fat, high sugar diet with drinking water containing five percent ethanol. Eighteen variable indexes were measured by biochemical examination, US,CT and ' H MRS. ROC analysis and Z test were used to compare the diagnostic efficacy of different clinical examinations. Results Among eighteen variable indexes,serum TC,ultrasound attenuation coefficient,liver CT value and ' H MRS fat peak area had the highest degree of relationship by biochemical examination, US, CT, ' H MRS in diagnosis of fatty liver, correlation coefficients were 0.886,0.483, -0. 764, 0. 558, and areas under curve were 0. 981, 0. 581, 0. 810, 0. 713, respectively. There were significant differences in areas under curve between every two groups except 'H MRS fat peak area and ultrasound attenuation coefficient, liver CT value. Conclusions The diagnostic values of imaging modalities in the hepatic steatosis grade, their order is CT >'H MRS> US; Serum TC maybe have important diagnostic value in evaluating hepatic steatosis grade,this is very worth further studying.