肝硬化患者大脑基底节和白质弛豫时间测量研究  

The study of T 1 and T 2 measurement in the basal ganglion and cerebral white matter in patients with hepatic cirrhosis

作　　者：李坤成[1] 付建新[2] 张旭[2] 杨小平[1] 王蕊[1] 赵富强[2] 

机构地区：[1]首都医科大学宣武医院医学影像学部放射科,北京100053 [2]首都医科大学生物医学工程学院

出　　处：《中华放射学杂志》2004年第12期1290-1293,共4页Chinese Journal of Radiology

摘　　要：目的　探讨肝硬化患者大脑基底节和白质的弛豫时间与肝硬化严重程度及血氨值的关系 ,评价MRI弛豫时间测量对肝硬化累及脑组织的诊断价值。方法　应用MRSE脉冲序列对 2 2例肝硬化患者 [其中男 2 0例 ,女 2例 ,平均年龄 (46 4± 8 1)岁 ]和 18位成人健康志愿者 [男 16例 ,女 2例 ,平均年龄 (42 4± 8 4 )岁 ]行MR检查 ,应用经典SE脉冲序列 2点法测量和计算苍白球、壳核、尾状核头、丘脑和大脑白质的T1和T2 值。在MR扫描后 1周内 ,对其中 8例患者行血氨水平测定。结果　 15例肝硬化患者T1WI可见基底节区信号增高 ,7例无明显异常改变。 7例T2 WI基底节区信号明显减低 ,15例无明显异常改变。肝硬化患者苍白球、壳核、尾状核头、丘脑与皮层下白质的T1值均与正常对照组差异有非常显著性意义 (P <0 0 1) ,ChildC级苍白球、壳核、尾状核头和丘脑的T1值与ChildB级间差异有非常显著性意义 (P <0 0 1) ,苍白球T1值与血氨值呈显著负相关 (r =- 0 790 ) ;除尾状核头外 ,苍白球、壳核、丘脑与皮层下白质的T2 值患者与对照组差异均无显著性意义 (P >0 0 5 )。结论　MRI大脑基底节T1值测量可用于评价肝硬化及其所致脑组织变性的严重程度。Objective To probe the relationship of T 1 and T 2 alterations in basal ganglion and cerebral white matter and the severity and degree of hepatic cirrhosis as well as the value of blood ammonia, and to evaluate the diagnostic value of T 1 and T 2 measurement for hepatic cirrhosis involve the brain Methods Twenty two patients [male 20, and female 2, mean age (46 4±8 1) years] with chronic liver cirrhosis and eighteen age matched adult healthy volunteers [male 16, and female 2, mean age (42 4±8 4) years] were examined by MRI The T 1 and T 2 value in the globus pallidus, putamen, head of caudate nucleus, thalami, and white matter of cerebrum were measured by two point method using classic spin echo sequences The blood ammonia of 8 patients was measured within one week after MR scanning Results The signal intensity increased in the basal ganglia in 15 cases with hepatic cirrhosis and no significant abnormal changes in 7 patients on T 1WI, however, the signal intensity decreased in the basal ganglia in 7 cases with hepatic cirrhosis and no significant abnormal changes in 15 cases on T 2WI There were significant difference ( P <0 01) for T 1 value in the globus pallidus, putamen, head of caudate nucleus, thalami, and white matter of cerebrum between the patients with hepatic cirrhosis and normal control groups The T 1 value of globus pallidus, putamen, head of caudate nucleus, thalami were positive correlated with the severity degree of hepatic cirrhosis, and the T 1 value of globus pallidus was significant negative correlation with the value of blood ammonia Except for the head of caudate nucleus, there were no significant difference ( P >0 05) for T 2 value in the globus pallidus, putamen, thalami, and white matter of cerebrum between patients with hepatic cirrhosis and normal control groups Conclusion Cerebral T 1 value measurement is useful in evaluating the severity degree of hepatic cirrhosis as well as the cerebral degeneration

关 键 词：肝硬化患者 苍白球 白质 尾状核 基底节 壳核 丘脑 弛豫时间 负相关 氨水 

分 类 号：R445.2[医药卫生—影像医学与核医学]