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The first part of the living donor liver 1.5T 1H-MRS clinical magnetic resonance spectroscopy (MRS) is a functional magnetic resonance imaging, is a basic principle of its chemical shift and spin coupling phenomenon using magnetic resonance imaging, quantitative determination of human energy metabolism a detection technique and the concentration of the compounds in the body, the chemical shift and spin-spin coupling two phenomena form the basis of spectroscopy. No damage of living organ tissue metabolism, biochemical changes. Its role in the central nervous system, prostate, benign and malignant breast disease diagnosis and differential diagnosis has been preliminary approved. Because the liver is the the biological individual substance metabolism and biotransformation vital organs, the liver has been a hot research MRS. The MRS imaging methods for the Study of the Liver 1H-MRS and 31P-MRS. Early studies mainly vitro specimens and animal experiments, multi-31P-MRS. These studies showed that, phosphorus spectrum usually can detect six kinds of resonance peaks, namely 1. Phosphate single esterase (PEM), 2. Inorganic phosphorus, 3. Phosphoric two esters (PDE) 4. Three phosphoric acid adenosine, 5. Α-three phosphorylated adenosine the 6.β-triphosphate, the peak height and peak area under the metabolite content directly related; 31P-MRS can provide an important basis for the identification of benign and malignant liver disease was found in the study of animal experiments, some metabolites with the degree of liver fibrosis increases and the degree of intrusion of different degree of hepatic inflammatory and cirrhosis ratings associated. 1H-MRS has also done a lot of research animals and isolated specimens that can detect liver mainly four kinds formant, they are: 1. Glycogen and glucose complex, choline, 3 Valley amide and glutamic acid complex, 4. lipid. As the research progresses, magnetic resonance spectroscopy technology continues to improve. Spectroscopy studies of the liver from the development of in vitro, animal studies to clinical application. Clinical studies of the liver 1H-MRS has been some progress in recent years, including 1H-MRS in the diagnosis and evaluation of fatty liver has been widely recognized and has done a lot of research to distinguish between benign and malignant liver nodules reached basic consensus. Preliminary study in the diagnostic evaluation of chronic hepatitis, cirrhosis, but has not yet formed a common standard. The purpose of this project is to clarify its role in the early diagnosis and assessment of liver cirrhosis by 1H-MRS study of normal subjects and patients with cirrhosis. 1H-MRS scan the subject first normal volunteers of different age and gender, to explore the scanning conditions to optimize the scan parameters; clear the characteristics of different age and sex normal human liver 1H-MRS, calculate the standard values ??of the metabolites and credible range. Subsequently, 1H-MRS scan complete clinical data of patients with cirrhosis, Compare cirrhosis patients and normal spectral distinction, compare and cirrhosis. Explore the early diagnosis of 1H-MRS to assess the feasibility of cirrhosis. This study showed that: 1, 1H-MRS scanning technology is an effective method of scanning, scan success rate of 91.9%. 2, human liver MRS can be seen the four major metabolite peaks, but does not appear in a constant in all subjects object. Male group of normal people glyu content is lower than the female group, the glx lip content male group than the female group the cho content there is no gender difference. cho / lip value male group, the ratio is lower than the female group. 4 normal people the cho value for more than 30 years of age group below 30 years of age group, the glx, lip, the cho / lip value of more than 30 years of age group above 30 years of age group, glyu no difference between the two groups. The content of cho and cho / lip values ??with age was negatively correlated with the lip, the glx age was positively correlated. 4, the group of patients with cirrhosis Cho peak and Glx peak increased, and a positive correlation with liver cirrhosis classification. 5, in the early diagnosis of liver cirrhosis, Glx than Cho sensitive in assessing its staging Cho accurately. The combination is an effective non-invasive method of early diagnosis and assessment of liver cirrhosis. Objective To explore the monomer prime hydrogen proton magnetic resonance spectroscopy (1H-magnetic resonance spectroscopy and 1H-MRS) technology imaging conditions, optimization of the MRS scan parameters; clear to normal human content of the compounds in the liver and the differences in the different age and gender groups. Methods This study included 50 normal subjects as the study of the different age and gender, including 29 males and 21 female patients, age 35.26 ± 14.2 years. 1.5T MRI instrument single voxel 1H-MRS study included object, the technology used to select a fixed-point to distinguish spectroscopy (pointed the resolved selective spectroscopy, PRESS). All information in the MR scanner to the SAGE software scan data processing, then to the the SAGE software that comes with the measurement and calculation formulas were used to measure the the related metabolites average peak. All data SPSS11. 5 software for statistical analysis, the significance level of 0.05. Results 1H-magnetic resonance spectroscopy is able to detect many of the compounds in normal human liver, such as glycogen and glucose complex (glycogen), choline (Choline), glutamine and glutamic acid complexes (glutamine and glutamate complex) as well as lipid (lipide). compounds content, there are differences in the different age and gender. Choline content of normal human liver and age is a negative correlation, no significant differences in the populations of the different gender. Glucose complex, glutamine and glutamic acid complexes and the lipid content of the presence of significant differences in the populations of different sex glutamine and glutamic acid complexes and lipid content and age were positively correlated, glucose complexes in different age groups showed no significant difference. Conclusion 1H-MRS is able to detect a variety of compounds metabolism in the liver, and can be measured quantitatively, to help study the physiological and biochemical changes of the liver disease, and to provide the basis for the early diagnosis of the disease. Objective: To study patients with cirrhosis proton magnetic resonance spectroscopy (1H-magnetic resonance spectroscopy, 1H-MRS) characteristics, to discuss the feasibility of proton magnetic resonance spectroscopy diagnosis of liver cirrhosis, provide a new noninvasive method for the early diagnosis of liver cirrhosis . Methods: 1.5T magnetic resonance analyzer 50 normal controls (control group) and 31 patients with varying degrees (child A in 16 cases; child B 9 cases; child C 6 cases) liver fibrosis sclerosis patients (case group). Single voxel 1H-MRS study the technology used to choose a fixed-point to distinguish spectroscopy (pointed resolved selective spectroscopy, PRESS). All information in the MR scanner to the SAGE software scan data processing, then to the the SAGE software that comes with the measurement and calculation formulas were used to measure the the related metabolites average peak. SPSS 13.0 statistical package for statistical analysis, when P lt; 0.05, the difference was statistically significant. Result: the normal group and the group of cases choline (choline, Cho) and glutamine, glutamic acid complex (glutamine and glutamate complex, Glx) peak height difference was statistically significant (P = 0.013 and 0.000, respectively); Cho peak height difference between Child A, B, C groups also statistically significant (P = 0.000), the Glx peak height differences between the two groups of Child A and Child C was statistically significant (P = 0.003). Glycogen and glucose complex (glycogen Glyu) and lipid (lipide, Lip) peak height differences, whether in groups or group was not statistically significant. Conclusion: 1.5T 1H-MRS can successfully by certain compounds peak distinguish between the control group and the cirrhosis group, and be able to distinguish between the different degrees of cirrhosis, which is a noninvasive method for the diagnosis of liver cirrhosis and to determine the extent of the considerable potential. The second part of the value of magnetic resonance diffusion tensor imaging in the diagnosis of hepatic fibrosis purpose by magnetic resonance diffusion tensor imaging (diffusion tensor imaging, DTI) with cirrhosis degree of correlation studies to explore in the evaluation of liver cirrhosis value. Methods The study included 50 normal controls (normal group, age 35.2 ± 14.2 years, 28 men and 22 women) and 37 patients with liver cirrhosis (age 41.1 ± 13.0 years, 22 men and 15 women). Cirrhosis classification information: child A 17 patients (age 35.0 ± 11.8 years, 14 men and 3 women), child B 12 patients (age 44.7 ± 14.0 years, five men and seven women), child C (age 48.7 ± 7.6 years, 3 men and 5 women). 32 of liver cirrhosis, five cases of cirrhosis schistosomes. GE Propeller HD 1.5T magnetic resonance instrument, diffusion tensor imaging acquisition single-shot echo-planar sequence. The data acquisition with AW4.2 workstation Functool software for processing. The choice of the region of interest in the process to avoid the bile duct, vascular select a measurement of the diffusion coefficient (Average diffusion coefficient, ADC) and anisotropy values ??(the Fractional anisotyopy, FA) in the right lobe and left lobe. SPSS 11.5 statistical software for statistical analysis, when P lt; 0.05, the difference was statistically significant. Results liver ADC values ??of the normal control group (1.54 ± 0.25) is higher than the case group (1.08 ± 0.32), FA values ??(0.46 ± 0.10) was lower than the case group (0.53 ± 0.13) were statistically significance (P lt; 0.05) . ADC values ??in the patient group with increasing child-pugh classification reduction in child A, child B and child C three groups ADC values ??were 1.33 ± 0.18, 1.02 ± 0.12 and 0.66 ± 0.27, FA values ??declined first and then higher in child A, child B and child C three groups in FA values ??were 0.42 ± 0.08, 0.56 ± 0.05 and 0.71 ± 0.41. Statistically significant differences among the groups. Conclusion MR-DTI with cirrhosis-related, is a sensitive means to check liver fibrosis was found in early lesions, clinical monitoring to make some contribution, is expected to provide for the early diagnosis of liver cirrhosis, a new non-invasive methods. The third part of the MRS and MR-DTI cirrhosis diagnosis, grading effect comparison purposes: to measure and compare MRS and MR-DTI cirrhosis diagnosis, grading effect. Methods: 87 patients with MR-DTI data of 81 cases of MRS subjects, clinical diagnosis and child hierarchical data by the ROC curve and boundary value analysis. The results: an independent predictor of FA, ADC, cho, the glx under the ROC curve is greater than 0.5, and P lt; 0.05, one of the area under the curve of the ADC value parallel joint experiments show that the area under the ROC curve of the MR-DTI is slightly higher than the MRS; ADC values ??in the control group, child A, B, C groups there is a significant difference (P values ??were 0.001,0.000,0.000) and other measurement values ??in the control group and the child A group difference was not statistically significance. Conclusion: MRS MR-DTI has a good effect on the diagnosis and grading of cirrhosis, and in particular the effect of MR-DTI better.
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