期刊文献+

轻微肝性脑病的MRI与^1H-MRS探讨 被引量:1

The value of MRI and ^1H-MRS in patients with minimal hepatic encephalopathy
下载PDF
导出
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。 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.
出处 《临床肝胆病杂志》 CAS 2010年第3期310-313,共4页 Journal of Clinical Hepatology
基金 深圳市科技局资助项目(200903057)
关键词 肝性脑病 磁共振成像 磁共振波谱学 hepatic encephalopathy magnetic resonance imaging magnetic resonance spectroscopy
  • 相关文献

参考文献15

  • 1Ferenci P,Lockwood A, Mullen K, et al. Hepatic encephalopathy - definition, nomenclature, diagnosis, and quantification : final report of the working party at the 11 th 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. 被引量:46
  • 3Das A, Dhiman RK, Saraswat VA, et al. Prevalence and natural history of sub clinical hepatic encephalopathy in cirrhosis [ J ]. J Gastroenterol Hepatol , 2001,16 (5) : 531 - 535.
  • 4Romero - Gomez M, Boza F, Garcia - Valdecasas MS,et al. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy [ J ]. Am J Gastroenterol, 2001,96 ( 9 ) : 2718 - 2723.
  • 5Rei V,Nath K, Sarawat VA, el al. Measurement of cytotoxic and interstitial components of cerebral edema in acute hepatic failure by diffusion tensor imaging [ J ]. J Magn Reson Imaging, 2008,28 ( 2 ) : 334 - 341.
  • 6钟碧慧,陈旻湖,王锦辉,袁育红,胡品津.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. 被引量:51
  • 7Groeneweg M, Moerland W, Quero JC, et al. Screening of subclinical hepatic encephalopathy [ J ]. J Hepatol,2000,32 ( 5 ) : 748 - 753.
  • 8Kim Y. High signal intensities on T1 - weighted MRI as a biomarker of exposure to manganese [ J ]. Industrial Health, 2004,42 ( 2 ) : 111 -115.
  • 9Olanow 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.
  • 10Singhal A, Nagarajan R, Kumar R,et al. Magnetic resonance T2 - relaxometry and 2D L - correlated spectroscopy in patients with minimal hepatic encephalopathy[ J ]. J Magn Reson Imaging,2009,30 (5) : 1034 - 1041.

二级参考文献5

  • 1朱权,张兆文.亚临床肝性脑的心理测验与诱发电位检查诊断研究[J].中华内科杂志,1993,32(10):676-678. 被引量:15
  • 2病毒性肝炎防治方案(试行)[J].中华传染病杂志,1995,13(4):241-247. 被引量:1767
  • 3Blei AT, Cordoba J. Hepatic encephalopathy. Am J Gastroenterol,2001, 96: 1968-1976.
  • 4Ferenci P, Lockwood A, Mullen K, et al. Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: final report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology, 2002, 35: 716-721.
  • 5Kircheis G, Wettstein M, Timmermann L, et al. Critical flicker frequency for quantification of low-grade hepatic encephalopathy.Hepatology, 2002, 35: 357-366.

共引文献93

同被引文献15

  • 1BrandaoLA,DominguesRC著.刘筠,廉宗潋译.脑磁共振波谱成像[M].天津:天津科技翻译出版公司,2005.10-11.
  • 2Kim Y. High signal intensities on Tl-weighted MRI as a biomarker of exposure to manganese[ J]. Industrial Health, 2004, 42 : 111.
  • 3Gupta RK, Dhiman RK. Magneitc resonance imaging and spectros- copy in hepatic encephalopathy [ J ]. Indian J Gastroenterol, 2003, 22 ( Suppl 2 ) : S45.
  • 4Singhal A, Nagarajan R, Kumar R, et al. Magnetic resonance T2- relaxometry and 2DL-correlated spectroscopy in patients with mini- mal hepatic encephalopathy[ J]. J Magn Reson Imaging, 2009, 30: 1034.
  • 5Rovira A, Cordoba J, Raguer N, et al. Magnetic resonance imaging measurement of brain edema in patients with live disease : resolution after transplantation[J]. Curr Opin Neurol, 2002, 15: 31.
  • 6Sijens PE, Alkefaji H, Lunsing RJ, et al. Quantitative muhivoxel ^1H MR spectroscopy of the brain in children with acute liver failure [J]. Eur Radiol, 2008, 18: 2601.
  • 7Binesh N, Huda A, Bugbee M, et al. Adding another spectral di- mension to ^1H magnetic resonance spectroscopy of hepatic encepha- lopathy[J]. J Magn Reson Imaging, 2005, 21: 398.
  • 8Castillo M. Proton MR spectroscopy of the brain [ J ]. Neuroimag Clin North Am, 1998, 8: 802.
  • 9邬海博,马林,蔡幼铨,李涛,李德军,梁丽.肝硬化患者脑基底节区MRI与MR波谱成像研究[J].中华放射学杂志,2007,41(11):1166-1168. 被引量:3
  • 10张勇,张金彪,李振芝,王鹏飞,孙海荣.磁共振波谱分析对轻微型肝性脑病患者的诊断价值[J].临床神经病学杂志,2009,22(2):105-107. 被引量:4

引证文献1

二级引证文献10

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部