获得性肝性脑部变性影像学表现及临床意义

Features and significance of acquired hepatocerebral degeneration on radiological images

目的探讨肝硬化患者获得性肝性脑部变性(AHCD)影像学特点及其与临床表现的相关性。方法 23例肝硬化失代偿患者(A组)、21例肝硬化代偿患者(B组)和30例正常人(C组)行颅脑MRI检查和食管钡餐检查,同时行Child-Pugh评分。在T1WI上测量豆状核和中脑信号强度,分析MRI和钡餐检查征象以及与临床表现关系。结果 MRI示A组脑部病变信号强度明显高于B、C组(P<0.05)。肉眼诊断:A组AHCD发病率高于B组(P<0.01),有食管静脉曲张患者AHCD发病率和Child-Pugh评分均较无静脉曲张患者高(P<0.01),有AHCD患者Child-Pugh评分高于无AHCD病人(P<0.01)。结论肝硬化失代偿是AHCD发病重要因素,颅脑MRI和食管钡餐检查能够反映病情的严重程度,为及早治疗提供重要影响学依据。

Objective To analyze the imaging findings of acquired hepatocerebral degeneration（AHCD） and their correlation with clinical manifestations.Methods Brain MRI and esophageal barium meal examination were performed in 23 cases with liver cirrhosis broken compensation（group A）,21 cases with liver cirrhosis in compensated stage （group B）,and 30 healthy subjects（group C）.Child-Pugh scoring was performed and signal intensity of lenticular nucleus and mesencephali were measured on T1WI.Results The signal intensity of AHCD was higher in group A than that in groups of B and C（P〈0.05）.The incidence of AHCD was higher in group A than that in group B on inspection（P〈0.01）.Patients with esophageal varices had higher mobidity of AHCD and Child-Pugh score than those without（P〈0.01）.Child-Pugh score in AHCD patients was higher than that in cases without on MRI.Conclusion Liver cirrhosis broken compensation is an important factor in development of AHCD.The findings of brain MRI and esophageal barium meal examination can reflect the degree of pathogenetic condition and provide the imaging evidences for early treatment.