轻微型肝性脑病患者楔前叶VBM-MRI研究

VBM MRI study of subregions of precuneus in patients with minimal hepatic encephalopathy

目的:探讨轻微型肝性脑病(MHE)患者楔前叶各亚区灰白质体积的变化特点及相关神经病理学机制。方法:15例健康志愿者(对照组)及15例MHE患者,首先行相关神经心理学量表测试,然后采用3.0T磁共振行头颅高分辨率3D-T1WI扫描,采用Dparsf软件中VBM-DARTEL分析方法对图像进行后处理,对两组受试者双侧楔前叶及其各亚区的灰白质体积进行测量和统计分析。结果:与对照组相比,MHE组患者左侧楔前叶4个亚区的灰质体积均以减少为主,其中楔前叶前部和中央区的体积轻度减少,后部和腹侧区的体积明显减少;右侧楔前叶4个亚区的灰质体积明显减少,且均较左侧更明显[P<0.05(AlphaSim校正)]。左侧楔前叶4个亚区的白质体积以增加为主,其中楔前叶前部和中央区的体积轻度增加,后部和腹侧区的体积明显增加;右侧楔前叶4个亚区的白质体积增加,且均较左侧更明显[P<0.05(AlphaSim校正)]。结论:基于VBM-DARTEL算法MRI可显示MHE患者楔前叶及其各个亚区灰白质体积的异常改变,有助于MHE病理生理学机制的研究。

Objective:To study the characteristics of gray and white matter volume changes and the related neurological mechanisms in the precuneus subregions of patients with minimal hepatic encephalopathy(MHE)using MRI with voxel-based morphometry(VBM).Methods:The neuropsychological test was performed on 15 normal subjects and 15 MHE patients,and then the high resolution 3D T 1WI were obtained and analyzed using 3.0T MR scanner and VBM DARTE based on Dparsf software.the volume of gray and white matter in the precuneus and its four subregions was statistically analyzed between MHE and normal group.Results:Compared with the control group,generally the volume of gray matter in the left precuneus decreased in MHE group,and slightly in the anterior and central subregion,but significantly in the posterior and the ventral subregion;the volume in the four subregions of right precuneus showed more obviously loss than that of the left.For the volume of white matter,four subregions of left and right precuneus increased(slightly in the anterior and central subregion,but significantly in the posterior and ventral subregion),and the increasing extent in right side was also more obvious than that in the left.Conlusion:MRI with voxel-based morphometry can reveal the volume changes of gray and white matter in the precuneus subregions of MHE patients,thus may play an important role in the early diagnosis of MHE and understanding of the mechanisms of nerve injury.