轻微肝性脑病的MRI与1H-MRS探讨

王俊萍; 叶红军; 杨莉丽; 王园园; 邹兵; 杜端明

轻微肝性脑病的MRI与1H-MRS探讨

1. 北京大学深圳医院消化科
2. 北京大学深圳医院放射科

基金项目:

深圳市科技局资助项目(200903057)；

详细信息

中图分类号: R747.9
计量
- 文章访问数: 3255
- HTML全文浏览量: 14
- PDF下载量: 759
- 被引次数: 0
出版历程
- 出版日期: 2010-03-20

The value of MRI and 1H-MRS in patients with minimal hepatic encephalopathy

Research funding:

摘要

摘要: 目的探讨轻微肝性脑病患者颅脑MRI及1H-MRS的代谢变化。方法 22例经神经心理测试诊断为轻微肝性脑病患者和13例年龄、性别和受教育程度相匹配的健康志愿者,行MRI、1H-MRS扫描,1H-MRS兴趣区为双侧基底节。结果 22例患者中17例双侧基底节在T1WI上可见高信号,NAA/Cr值患者组与健康对照组之间差异无显著性（P>0.05）,而mI/Cr和Cho/Cr值患者组与健康对照组比较显著降低（L:P<0.01;R:P<0.01）。结论 T1WI高信号是诊断轻微肝性脑病较为特征性征象,1HMRS能够无创性观察到轻微肝性脑病患者的脑代谢异常,有助于揭示肝性脑病的病理生理机制。
- 肝性脑病 /
- 磁共振成像 /
- 磁共振波谱学
Abstract: Objective To investigate the signal changes and metabolic alterations in the brain by using MRI and proton magnetic resonance spectroscopy (1H-MRS) in patients with minimal hepatic encephalopathy (MHE) . Methods 22 patients with MHE were diagnosed by neuropsychological tests. MRI plain scan and 1H-MRS were performed for the patients and 13 age and education matched healthy controls. Localized magnetic resonance spectra were acquired in the bilateral basal ganglia. Results Bilateral symmetrical hyper intensity in basal ganglia was detected in 17 of the patients. NAA/Cr levels had no significant difference between the patients and healthy controls (P>0.05) . The ratios of mI/Cr and Cho/Cr of the bilateral basal ganglia were significantly reduced in MHE patients (L:P<0.01;R: P<0.01) . Conclusion Signal hyper intensities and the mI/Cr and Cho/Cr ratios measured in the basal ganglia correlated significantly with the MHE. MRI and 1H-MRS in basal ganglia play a significant role in the pathophysiology of MHE.
- hepatic encephalopathy /
- magnetic resonance imaging /
- magnetic resonance spectroscopy

HTML全文

参考文献(15)

[1]Ferenci P, Lockwood A, Mullen K, et a1.Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification:final report of the working party at the11th World Congresses of Gastroenterology, Vienna, 1998[J].Hepatology, 2002, 35 (3) ∶716-721.

[2]王宇明.肝性脑病的最新共识[J].中华肝脏病杂志, 2003, 11 (5) ∶261-264.

[3]Das A, Dhiman RK, Saraswat VA, et a1.Prevalence and natural histo-ry of sub clinical hepatic encephalopathy in cirrhosis[J].J Gastroen-terol Hepatol, 2001, 16 (5) ∶531-535.

[4]Romero-Gomez M, Boza F, Garcia-Valdecasas MS, et a1.Subclin-ical hepatic encephalopathy predicts the development of overt hepatic encephalopathy[J].Am J Gastroenterol, 2001, 96 (9) ∶2718-2723.

[5]Rei V, Nath K, Sarawat VA, et al.Measurement of cytotoxic and in-terstitial components of cerebral edema in acute hepatic failure by dif-fusion tensor imaging[J].J Magn Reson Imaging, 2008, 28 (2) ∶334-341.

[6]钟碧慧, 陈渂湖, 王锦辉, 等.数字连接试验对诊断亚临床肝性脑病的价值[J].中华内科杂志, 2001, 40 (1) ∶13-15.

[7]Groeneweg M, Moerland W, Quero JC, et al.Screening of subclinical hepatic encephalopathy[J].J Hepatol, 2000, 32 (5) ∶748-753.

[8]Kim Y.High signal intensities on T1-weighted MRI as a biomarker of exposure to manganese[J].Industrial Health, 2004, 42 (2) ∶111-115.

[9]Olanow CW, Good PF, Shinotoh H, et al.Manganese intoxication in the rhesus monkey:a clinical, imaging, pathological, and biochemical study[J].Neurology, 1996, 46 (1) ∶492-498.

[10]Singhal A, Nagarajan R, Kumar R, et al.Magnetic resonance T2-relaxometry and2D L-correlated spectroscopy in patients with min-imal hepatic encephalopathy[J].J Magn Reson Imaging, 2009, 30 (5) ∶1034-1041.

[11]Binesh N, Huda A, Bugbee M, et al.Adding another spectral di-mension to1Hmagnetic resonance spectroscopy of hepatic encepha-lopathy[J].J Magn Reson Imaging, 2005, 21 (4) ∶398-405.

[12]Stanley JA.In vivo magnetic resonance spectroscopy and its applica-tion in neuropsychiatric disorders[J].Can J Psychiatry, 2002, 47 (4) ∶313-314.

[13]Tarasow E, Panasiuk A, Siergiejezyk L, et al.MR and1HMR spec-troscopy of the brain in patients with liver cirrhosis and early stages of hepatic encephalopathy[J].Hepatogastroenterology, 2003, 50 (54) ∶2149-2153.

[14]Weissenbom K, Bokemeyer M, Ahl B, et a1.Functional imaging of the brain in patients with liver cirrhosis[J].Metaholic Brain Dis-ease, 2004, 19 (3/4) ∶269-280.

[15]Rovira A, Cordoba J, Raguer N, et a1.Magnetic resonance imaging measurement of brain edema in patients with liver disease:resolution after transplantation[J].Curr Opin Neurol, 2002, 15 (6) ∶731-737.

施引文献

资源附件(0)

访问统计