基底节区^1H-MRS检查对早期诊断轻微肝性脑病的价值

Value of Basal Ganglia Region 1H-MRS in Early Diagnosis of Minimal Hepatic Encephalopathy

目的:分析轻微肝性脑病(mHE)基底节区1H-MRS改变对早期诊断mHE的价值。方法:选择肝硬化患者30例行数字连接实验A(NCT-A)、数字符号实验(DST),根据结果分为肝硬化组和mHE组,其中肝硬化组12例,mHE组18例,选择年龄和教育程度相匹配健康志愿者12例为正常对照组;行MR基底节区相同感兴趣区1H-MRS检查,测量双侧尾状核头和豆状核的Mi、Glx、Cho、NAA、Cr含量,计算Mi/Cr、Glx/Cr、Cho/Cr、NAA/Cr、Glx/Mi比值,进行统计学分析。结果:肝硬化组和mHE组Mi/Cr、Cho/Cr比值较正常组降低,Glx/Cr、Glx/Mi比值较正常组升高;基底节区Mi/Cr、Glx/Cr、Cho/Cr比值与正常对照组比较,差异有统计学意义(P<0.05),在肝硬化组和mHE组之间无统计学差异(P>0.05);基底节区NAA/Cr比值在三组之间均无统计学差异(P>0.05),三组之间基底节区Glx/Mi比值差异有统计学意义(P<0.05)。结论:基底节区1H-MRS检查对临床早期诊断mHE具有重要的价值。

Objective： To investigate the alterations of basal ganglia region ^1H-MRS in minimal he- patic encephalopathy （milE） patients , and to explore the value of basal ganglia region ^1H-MRS in early diagnosis of mllE. Methods： Thirty patients with liver cirrhosis （LC） were divided into two groups according to the results of number connect test （NCT） and digital symbol test （DST） ： mile group （n = 18） and LC group （n = 12）. Twelve age and education matched healthy volunteers served as normal control group. I H-MRS of the basal ganglia same interesting region were performed. Mi, Glx, Cho, NAA and Cr were measured respectively in bilateral head of caudate nucleus and lenticular nucleus. The ratios of Mi/Cr, GLx/Cr, Cho/Cr, NAA/Cr and Glx/Mi were calculated. Results： Compared with control group, the ratios of Mi/Cr and Cho/Cr decreased and the ratios of Glx/Cr, Glx/Mi increased in mile group and LC group, and the differences were significant （ P 〈 0. 05 ）. No statistical difference was found in bii/Cr, Glx/Cr and Cho/Cr ratios between mile group and LC group （P 〉 0. 05 ）. No statistical difference was found in NAA/Cr ratios among the three groups （P 〉 0. 05 ）. There were statistical differences in Glx/Mi ratio among the three groups（ P 〈 0. 05 ）. Conclu- sions： Basal ganglia region ^1 H-MRS contributes to early diagnosis of minimal hepatic encephalopathy.