| 姜滨,沈文,张龙江,尹建忠,朱志军,祁吉.磁化传递成像定量研究肝硬化肝性脑病患者肝移植前后的脑改变[J].中国医学影像技术,2009,25(4):581~584 |
| 磁化传递成像定量研究肝硬化肝性脑病患者肝移植前后的脑改变 |
| Quantitative analysis of brain changes of hepatic encephalopathy with magnetization transfer imaging |
| 投稿时间：2008-11-13 修订日期：2009-01-03 |
| DOI： |
| 中文关键词: 肝性脑病 肝硬化 磁共振成像 肝移植 |
| 英文关键词:Hepatic encephalopathy Hepatic cirrhosis Magnetic resonance imaging Liver transplantation |
| 基金项目: |
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| 中文摘要: |
| 目的 利用磁化传递成像(MTI)技术定量分析肝硬化肝性脑病(HE)患者肝移植手术前后脑内水含量的变化。方法 对37例肝硬化HE患者和22名健康志愿者行MR扫描,并于肝移植术后1个月、3个月或1年对30例患者随访,测量额、顶、枕叶白质、尾状核头、壳核、苍白球、丘脑各兴趣区的磁化传递率(MTR),在T1WI图像上测量壳核和苍白球的信号强度计算GPI。结果 ①术前肝硬化HE患者组各部位的MTR值均较对照组低(P均<0.001),GPI指数显著升高(t=－6.40,P=0.000)。②术后1个月肝硬化HE患者组顶叶、额叶、尾状核、苍白球和枕叶的MTR值高于术前(P均<0.05);术后3个月各部位的MTR值均高于术后1个月(P均<0.05)。③与术前相比,术后1个月、3个月GPI值逐渐降低,但仍与对照组有差异。④各时间点MTR值、GPI指数与神经心理学测试无相关性。结论 肝硬化HE患者脑水肿是可逆性的。MTI可以作为肝移植后脑代谢恢复状况的随访监测方法。 |
| 英文摘要: |
| Objective To observe the changes of the water content in the brain of liver cirrhotic patients with hepatic encephalopathy (HE) before and after liver transplantation (LT) with magnetization transfer ratio (MTR). Methods A total of 37 patients of liver cirrhosis with HE and 22 controls were enrolled in the study, and brain MRI was performed.Thirty patients were followed up at 1 month, 3 months or 1 year after LT. MTR was calculated in 7 ROIs including the white matter of frontal lobe, parental lobe, occipital lobe, caudate head, putamen, globus pallidus and thalamus. Signal intensity of putamen and globus pallidus was measured on T1WI to calculate GPI. Results ①Compared with controls, MTR of patients with hepatic cirrhosis significantly decreased in all ROIs (P＜0.001) and GPI increased (t=－6.40, P=0.000) before operation. ②One month after LT, MTR of parental lobe, frontal lobe, caudate head and globus pallidus significantly increased in cirrhotic patients compared with those before LT. MTR of all the ROIs increased 3 months after LT. ③The improvement of GPI was progressive and did not normalized at 3 months after LT. ④There was no correlation between MTR, GPI and NP tests before and 1 month, 3 months after LT. Conclusion Brain edema in the brain of patients with liver cirrhosis is reversible and MTI is a helpful method in follow-up of the changes after LT. |
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