邬海博,马林,蔡幼铨,李涛.亚临床肝性脑病患者脑MRI与1H MRS研究[J].中国医学影像技术,2007,23(9):1282~1284
亚临床肝性脑病患者脑MRI与1H MRS研究
投稿时间:2007-02-10  修订日期:2007-04-25
DOI:
中文关键词:  肝硬化  肝性脑病  磁共振成像  磁共振波谱
英文关键词:Cirrhosis  Hepatic encephalopathy  Magnetic resonance imaging  Magnetic resonance spectroscopy
基金项目:国家"十五"科技攻关计划项目(2004BA714B05-01)。
作者单位E-mail
邬海博 北京大学第三医院放射科,北京 100083  
马林 中国人民解放军总医院放射科,北京 100853 cjr.malin@vip.163.com 
蔡幼铨 中国人民解放军总医院放射科,北京 100853  
李涛 中国人民解放军总医院放射科,北京 100853  
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中文摘要:
      目的 利用MRI及1H-MRS研究有与没有亚临床肝性脑病的肝硬化患者基底节区信号变化与代谢改变。方法 27例肝硬化患者进行MRI与基底节区MRS扫描,其中男22例,女5例,年龄29~62岁,平均43岁,其中14例肝硬化患者有亚临床肝性脑病(经数字连接试验及符号数字试验测试)。18例年龄匹配的健康志愿者作对比,其中男13例,女5例,年龄24~51岁,平均38岁。结果 有与没有亚临床肝性脑病的肝硬化患者结果及正常对照组间的NAA/Cr无显著性差异(P>0.05)。没有亚临床肝性脑病的肝硬化患者及正常对照组间苍白球的高信号强度值、mI/Cr与Cho/Cr无显著性差异(P>0.05)。有与没有亚临床肝性脑病的肝硬化患者间苍白球的高信号强度值、mI/Cr与Cho/Cr有显著性差异(P<0.001)。结论 肝硬化患者的亚临床肝性脑病与苍白球的高信号、基底节区mI/Cr、Cho/Cr有明显相关性。基底节区MRI与1H-MRS对判断是否有亚临床肝性脑病有重要的临床意义。
英文摘要:
      Objective To study the signal changes and metabolic alterations in the basal ganglia (BG) by using MRI and proton magnetic resonance spectroscopy (1H-MRS) in patients with subclinical hepatic encephalopathy (SHE). Methods MRI and 1H-MRS in the basal ganglia in 27 patients (22 males, 5 females, the age ranged from 29 to 62 years, mean age 43 years) with definite liver cirrhosis were studied. Fourteen patients were classified as having SHE evaluated by number connection test (NCT)and symbol digit test (SDT). Eighteen age-matched healthy volunteers (13 males, 5 females, the age ranged from 24 to 51 years, mean age 38 years) underwent MRI and 1H-MRS for comparison. Results NAA/Cr levels showed no statistical difference among patients with and without SHE and the control group (P>0.05). Values of signal hyperintensities in globus pallidus and ratios of mI/Cr and Cho/Cr showed no differences between the control group and the patients without SHE (P>0.05), whereas they were significantly different in patients without and with SHE (P<0.001). Conclusion Signal hyperintensities in globus pallidus and the mI/Cr and Cho/Cr ratios measured in the BG of patients correlated significantly with the SHE. MRI and 1H-MRS in BG play significant roles in the determination of SHE.
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