超高场强磁共振波谱分析对轻微型肝性脑病
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张金彪

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Diagnosis Valuation of Proton Magnetic Resonance Spectroscopy on Patients with Minimal Hepatic Encephalopathy
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    目的: 研究MRS对轻微型肝性脑病(MHE)患者的诊断价值。方法 应用3.0 MR机对33例MHE患者和46例没有轻微型肝性脑病的肝硬化患者进行了扣带回和右侧前额叶的单体素点分辨自旋回波波谱序列扫描。计算N-乙酰天门冬氨酸(NAA)、肌酐(Cr)、胆碱(Cho)、肌醇(MI)和谷氨酰胺复合物(Glx)的峰下面积,计算NAA/Cr、Cho/Cr、MI/Cr、Glx/Cr,并与30例健康体检者(正常对照组)比较。33例在 MR检查前后一周内进行了静脉血氨水平测定。结果:与正常对照组相比,有轻微肝性脑病患者扣带回和右侧前额叶的Cho/Cr、MI/Cr 显著降低(P<0.01和 P0.05),没有轻微肝性脑病的肝硬化患者与正常对照组比较MI/Cr有显著性差异(P0.05)。扣带回与右侧额叶的Glx/Cr比值与血氨浓度呈正相关,Cho/Cr 和MI/Cr的比值与血氨浓度呈负相关。 结论:MHE患者MRS检查显示扣带回和右侧前额叶Cho、MI水平降低,Glx水平升高;扣带回与右侧额叶的MRS指标与血氨之间存在相关关系,MRS对MHE的诊断有显著价值;扣带回和额叶可作为检测肝硬化患者脑改变的一个敏感部位。

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    Objective: To study diagnostic valuation of proton magnetic resonance spectroscopy on patients with minimal hepatic encephalopathy Methods: MRS of cingulated cortex and prefrontal lobe were acquired using PRESS sequences in Thirty-three patients with MHE and forty-six patients without MHE and 30 controls. Peak area of each metabolite, including NAA , Cr , Cho , MI , Glx and their ratios to Cr were computed , respectively. Then compared with the controls,Venous ammonia was measured in 33 patient s with MHE. Results: Compared with controls , patients with MHE showed significant decreased Cho/ Cr , MI/ Cr and significant elevated Glx/ Cr in cingulate cortex and prefrontal lobe . Glx/ Cr and Cho/ Cr were significantly different in patients without and with MHE (P0.05). MI/ Cr were significantly different in patients without MHE and the control group (P0.05)。 The results also showed a significantly positive correlation between Glx/Cr in both cingulate cortex and prefrontal lobe and the venous ammonia concentration and a significantly negative correlation between Cho/Cr and MI/Cr and the venous ammonia concentration. Conclusion: patients with MHE showed significant decreased Cho , MI and significant elevated Glx in cingulate cortex and prefrontal lobe on MRS ; The results also showed a significantly correlation between metabolite changes in both cingulated cortex and prefrontal lobe and the venous ammonia concentration, diagnostic valuation of MRS was significant to MHE; cingulate cortex and prefrontal lobe might be a sensitive location in detecting MHE .

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张金彪 张勇 王晶 李振芝456.超高场强磁共振波谱分析对轻微型肝性脑病[J].国际神经病学神经外科学杂志,2009,(4):298-302111222. Diagnosis Valuation of Proton Magnetic Resonance Spectroscopy on Patients with Minimal Hepatic Encephalopathy[J]. Journal of International Neurology and Neurosurgery,2009,(4):298-302

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  • 收稿日期:2009-04-14
  • 最后修改日期:2009-07-31
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  • 在线发布日期: 2009-08-28
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