MR And Clinic Study Of Chronic Diffuse Liver Disease

Part1Fatty Liver in MR Susceptibility Weighted ImagingObjective:The aim of this study was to investigate the appearance of liver fat deposition in susceptibility weighted imaging of3.0T MR scanner.Methods and materials:15pure liver patients and20healthy controls underwent abdomen conventional and multi-echo susceptibility weighted sequence (Eswan) scanning at3.0T MR scanner. The corrected phase and merged magnitude images of Eswan were obtained through post-processing station respectively. The signal intensity of the liver tissue (Slliver), paravertebral muscle (SImuscle) and vertebra(SIvertebr) were measured on magnitude imaging, compared to the SImuscle and SIvertebr, the relative liver signal intensity-rSI1?rSI2were calculated. Data analyses were performed using17.0SPSS software. The means of the above signal intensity values between healthy and fatty liver groups were evaluated using t-test. P<0.05was considered to indicate a statistically significant difference.Results:The liver of the fatty liver patient showed reduced signal intensity on the magnitude imaging and disorderly high signal dotting as the appearance of the vertbra on the phase imaging. The means of the Slliver?rSI1?rSI2showed significant difference between the two groups (P<0.05)Conclusions:The fatty deposition could be detected on the Eswan sequence. The dephasing and shortened T2*effects on the susceptibility weighted imaging are also attributed to the fatty deposition. Part2Liver Iron Overload and HCC in Chronic Liver DiseasesObjective:The aim of this study was to investigate the appearance of liver fat deposition and siderotic nodules (SN) of chronic liver diseases in susceptibility weighted imaging of3.0T MR scanner. To explore the relationships between HCC and age, SN and liver cirrhosis background, the relationships between gender and HCC, SN were also discussed. Methods and materials:55chronic liver diseases patients (38cases with liver cirrhosis,17cases with chronic hepatitis) and20healthy controls underwent abdomen conventional and multi-echo susceptibility weighted sequence (Eswan) scanning at3.0T MR scanner. The corrected phase and merged magnitude images of Eswan were obtained respectively through post-processing station. The SIliver and rSI2were measured and calculated on magnitude imaging. Data analyses were performed using17.0SPSS software. The means of SIliver and rSI2values between all groups were evaluated using t-test and one way ANOVA with SNK-q-test. Among the chronic liver diseases groups, the relationships between HCC and age, SN and liver cirrhosis background, the relationships between gender and SN were evaluated using a Fisher's exact test. The relationship between HCC and the distribution of the SN was evaluated by Mann-Whitney U Test. P<0.05was considered to indicate a statistically significant difference.Results:The chronic liver diseases group showed four manifestations according the conditions of the fatty deposition and SN:a. fatty deposition alone, b. fatty deposition with SN, c. SN alone, d. neither. The means of the SIliver rSI2among a, b and pure fatty liver group showed no significant difference. Except the age and liver cirrhosis background, the prevalence of SN showed significant difference between HCC groups. The prevalence of SN showed significant difference between premenopausal and postmenopausal women.Conclusions:Eswan sequence showed the liver SN very well. The liver fatty deposition and SN often coexist in chronic diseases, the SN may not always contribute to the shortened T2*effect of the background liver tissues in susceptibility weighted imaging. The SN is related to HCC, Gender is related closely to the HCC and SN. Part3Preliminary Study of Liver1H-MRS in Chronic Liver Disease PatientsObjective:The aim of this study was to investigate preliminarily the manifestations of liver1H MRS of chronic liver diseases at3.0T MR scanner. To explore the relationships between serum biochemical tests, reserved liver function and choline chemistries compounds peak (CCC) in liver1H MRS. Methods and materials:33chronic liver diseases patients (22cases with liver cirrhosis,11cases with chronic hepatitis) and10healthy controls underwent liver3.0T1H MRS Press sequence scanning. The spectroscopy was processed by Sage post-processing software. The ratio of CCC peak and water peak was obtained through post processing. Data analyses were performed using17.0SPSS software. The patients were divided into two groups:high CCC peak and little or no CCC peak group. The difference of serum alanine aminotransferase (ALT), bilirubin between groups was evaluated using a Fisher's exact test. The difference distribution of the serum albumin scores, Child-Pugh classifications between groups were evaluated by Mann-Whitney U Test. P<0.05was considered to indicate a statistically significant difference.Results:There are no CCC peaks in healthy controls. In patients group,5cases showed no CCC peak,24cases showed it, of the24cases,14with high CCC peaks, the mean of the ratio was0.371±0.066,10with little CCC peaks, the mean of the ratio was0.070±0.016. The serum bilirubin, Child-Pugh classifications between groups had significant difference. The serum ALT, albumin scores between groups had no significant difference.Conclusions:High CCC peak in liver1H MRS of chronic liver diseases patients is correlated with serum bilirubin. Some of the bile component, abnormal lipid metabolism and hepatocyte mitosis associated with cholestasis may contribute to the high CCC peak. Part4Splenic Siderotic Nodules in Patients with Liver Cirrhosis: MR Appearance and Clinical SignificanceObjective:The aim of this study was to investigate the prevalence of the splenic siderotic nodules (SNs) in susceptibility weighted imaging of3.0T MR scanner. To explore the relationships between splenic SNs and hypersplenism, splenomegaly, varices and reserved liver function.Methods and materials:41chronic liver diseases patients and20healthy controls underwent abdomen conventional and multi-echo susceptibility weighted sequence (Eswan) scanning at3.0T MR scanner. The corrected phase and merged magnitude images of Eswan were obtained respectively through post-processing station. The spleen volumes of liver cirrhosis patients were measured. The spleen volumes and the number of splenic SNs on magnitude imaging were graded into three classes. Data analyses were performed using17.0SPSS software. The means of spleen volumes between hypersplenism groups, splenic SNs groups were evaluated using t-test. The difference of grades of splenogemaly and splenic SNs between hypersplenism groups, the Child-Pugh classifications and prevalence of varices between splenic SNs groups were evaluated using Mann-Whitney U Test. The relationship between spleen and splenic SNs grades was analyzed by spearman-rho method. P<0.05was considered to indicate a statistically significant difference.Results:The prevalence of slpenic SNs was78%in liver cirrhosis according Eswan sequence in the present study. The mean of spleen volumes between hypersplenism groups, SNs groups both showed significant difference. The spleen volume had significant positive related to the grades of SNs. The significant difference of the Child-Pugh classification was showed between SNs groups. The grades of SNs between varices groups had significant difference. Conclusions:The Eswan sequence is superior to other known sequence in detecting splenic SNs. Splenic SNs is correlated closely with thrombocytopenia, splenomegaly and Child-Pugh classification. Heavily splenomegaly and massive splenic SNs are consistent well with hypersplenism. The SNs is also closely correlated with varices, it is important to alert the varices bleeding on the condition of massive splenic SNs in cirrhosis patients.