ABSTRACT: The purpose of this study was to evaluate the clinical application of imaging technology in the quantitative assessment of fatty liver with magnetic resonance imaging (MRI) and proton MR spectroscopy.
Overall 36 patients with diffuse fatty liver who had undertaken the computed tomography (CT) scan, MRI and proton MR spectroscopy (1H MRS) were analyzed. Their body mass index (BMI) was measured and their liver to spleen CT ratio (L/S) calculated on the plain CT scan. MR T1-weighted imaging (T1WI) was obtained with in-phase (IP) and out-of-phase (OP) images. T2-weighted imaging (T2WI) was acquired with or without the fat-suppression technique. The liver fat content (LFC) was quantified as the percentage of relative signal intensity loss on T1WI or T2WI images. The intrahepatic content of lipid (IHCL) was expressed as the percentage of peak value ratio of lipid to water by 1H MRS.
The results of BMI measurement, CT L/S ratio, LFC calculated from MR T1WI and T2WI images, as well as IHCL measured by 1H MRS were 27.26 +/- 3.01 kg/m2, 0.88 +/- 0.26, 13.80 +/- 9.92%, 40.67 +/- 16.04% and 30.98 +/- 20.43%, respectively. The LFC calculated from MR T1WI, T2WI images and IHCL measured by 1H MRS correlated significantly with the CT L/S ratio (r = -0.830, P = 0.000; r = -0.736, P = 0.000; r = -0.461, P = 0.005, respectively). BMI correlated significantly only with the liver fat contents measured by T1WI IP/OP and 1H MRS (r = -0.347, P = 0.038; r = -0.374, P = 0.025, respectively).
CT, MR imaging and 1H MRS were effective methods for the quantitative assessment of LFC. The MR imaging, especially 1H MRS, would be used more frequently in the clinical evaluation of fatty liver and (1)H MRS could more accurately reflect the severity of fatty liver.
Journal of Digestive Diseases 11/2009; 10(4):315-20. · 1.59 Impact Factor
ABSTRACT: To evaluate the clinical value of MR multi-imaging techniques in diagnosing and preoperative assessment of pancreaticobiliary tumor.
MR multi-imaging techniques, including MR cross-sectional imaging, MR cholangiopancreatography (MRCP) and 3D dynamic contrast-enhanced MR angiography (3D DCE MRA), were performed to make prospective diagnosis and preoperative evaluation in 28 patients with suspected pancreaticobiliary tumors. There were 17 cases of pancreatic adenocarcinoma, 8 cases of biliary system carcinoma and 3 cases of non-neoplastic lesions.
Using MR multi-imaging techniques, the accuracy in diagnosing the patients with pancreaticobiliary tumors was 89.3% (25/28). The accuracy in detecting the range of tumor invasion was 80.3% (57/71). The sensitivity, specificity, accuracy, positive and negative predictive value of MR multi-imaging techniques in preoperative assessment of the resectability of pancreaticobiliary tumor were 83.3%, 89.5%, 88.0%, 71.4%, and 94.4%, respectively. There was well diagnostic consistency between MR multi-imaging techniques and CT (kappa = 0.64, P<0.01). The fusion image could be made from MRCP and 3D DCE MRA images.
MR multi-imaging techniques can integrate the advantages of various MR images. The non-invasive "all-in-one" MR imaging protocol is the efficient method in diagnosing, staging and preoperative assessment of pancreaticobiliary tumor.
World Journal of Gastroenterology 07/2005; 11(24):3756-61. · 2.47 Impact Factor
ABSTRACT: To investigate the clinical value of 2-D magnetic resonance imaging (MRI) with 3-D reconstruction techniques for the preoperative diagnosis and TNM-staging of gastric cancer.
Using a Philips Gyroscan NT 1.0T superconductive unit, MRI using the water-filling method was performed in 15 patients with suspected gastric cancers. The 2-D MRI sequences included TSE-T1WI, TSE-T2WI and fat suppression (SPIR). The source images of magnetic resonance hydrography (heavily TSE-T2WI sequence) were reconstructed using the Philips EasyVision viewing workstation. Four 3-D postprocessing algorithms, including maximum intensity projection, surface shaded viewing, volume rendering and virtual endoscopy, were performed and compared with the results of a barium study and endoscopy. All 15 patients with 16 gastric cancers had their diagnosis confirmed by postoperative pathological findings.
2-D MRI and 3-D reconstruction images were successfully obtained for all 15 patients. The maximum intensity projection, surface shaded viewing, and volume rendering images corresponded to the upper gastrointestinal series findings, and the virtual endoscopy images corresponded to the gastroscopic views. In 16 gastric lesions, MRI correctly diagnosed 14 (87.5%) advanced gastric cancers, and the tumor location, size and classification were also accurately identified. The accuracy of MRI for determining the preoperative TNM stage was 64.3% (9/14), and there was significant correlation between these results and those from the histopathological studies (P < 0.01). Based on T, N and M factors, the staging accuracy of MRI was 71.4% (10/14), 57.1% (8/14) and 85.7% (12/14), respectively.
2-D MRI with 3-D reconstruction is an effective method for the preoperative diagnosis and TNM staging of gastric cancer. However, the detection of early cancers or benign lesions and N-staging should be further studied.
Chinese Journal of Digestive Diseases 02/2005; 6(4):159-64.
ABSTRACT: To evaluate the clinical value of various imageological methods in diagnosing the pancreato-biliary diseases and to seek the optimal procedure.
Eighty-two cases of pancreato-biliary diseases confirmed by surgery and pathology were analyzed. There were 38 cases of cholelithiasis, 34 cases of pancreato-biliary tumors and 10 other cases. The imageological methods included B-US, CT, ERCP, PTC, cross-sectional MRI and MR cholangiopancreatography (MRCP).
The accuracy rate of MRCP in detecting the location of pancreato-biliary obstruction was 100%. In differentiating malignant from benign obstruction, the sensitivity of the combination of MRCP and cross-sectional MRI was 82.3%, the specificity was 93.8%, and the accuracy rate was 89.0%. The accuracy rate for determining the nature of obstruction was 87.8%, which was superior to that of B-US (P=0.0000) and CT (P=0.0330), but there was no significant difference between direct cholangiopancreatography and the combination of MRCP and conventional MRI (P=0.6666).
In most cases, MRCP can substitute direct cholangiopancreatography for diagnosis. The combination of MRCP and cross-sectional MRI should be considered as an important means in diagnosing the pancreato-biliary diseases, pre-operative assessment and post-operative follow-ups.
World Journal of Gastroenterology 01/2004; 9(12):2824-7. · 2.47 Impact Factor