肝性脊髓病7例颅脑MRI表现及临床意义  

Clinical significance and brain MRI features of hepatic myelopathy in 7 cases

作　　者：付学锋[1] 万东君[1] 张新宇[1] 李玉荣[1] 

机构地区：[1]兰州军区兰州总医院干部病房干三科,甘肃兰州730050

出　　处：《局解手术学杂志》2013年第5期518-519,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的分析肝性脊髓病(HM)患者颅脑MRI表现并讨论其临床意义。方法确诊为HM男性患者7例,年龄33～58岁。有慢性肝硬化病史1～11年,乙肝后肝硬化4例,丙肝后肝硬化1例,慢性酒精性肝硬化2例,其中曾行脾切除及门脉分流术4例。所有患者均行GE 1.5 T超导MRI常规扫描、颅脑CT、MRI、肝功能和血氨等检查,4例行脊髓MRI。结果 7例患者中颅脑CT有轻度脑萎缩2例,脊髓MRI无异常信号4例。MRI扫描结果,7例颅脑对称性双侧苍白球、3例于中脑大脑脚及内囊前肢T1WI像不同程度的高信号,7例T2WI像和FLAIR无异常表现。结论 HM时颅脑MRI苍白球特征性改变是T1WI高信号,脊髓MRI变化不明显,这一变化有助于HM的诊断。Objective To analyze MRI features of brain in patients with hepatic myelopathy （ HM ） and discuss their clinical signifi- cance. Methods 7 male patients aged 33 - 58 years old who were diagnosed as HM were selected as the object of study. There were patients with chronic liver disease 1 to 11 years, including 4 cases of liver cirrhosis after liver hepatitis B, 1 cases of liver cirrhosis after hepatitis C, 2 cases with chronic alcoholic cirrhosis. All the patients were examed through GE signa 1.5T HD eehospeed scanner, cerebral CT, MRI, liver function and blood ammonia, and 4 cases of them were performed spine MRI. Results Among the 7 patients, there were 2 cases of mild atrophy of brain through brain CT, and 4 cases were of no abnormal signal through spinal MRI. The results of MRI scan showed that 7 cases of brain were symmetrically bilateral globus pallidus, 3 cases of different degree T1WI signal increase occurred in cerebral peduncle and anterior limb of internal capsule, and there was no abnormal findings in terms of T2WI and FLAIR in the 7cases. Conclusion When HM happened, T1WI signal increase wass the characteristic change of globus pallidus through craniocerebral MRI, and there wass no obvious change in spinal MRI. The results would be helpful during the diagnosis of HM.

关 键 词：肝性脊髓病 磁共振成像 肝硬化 诊断 

分 类 号：R744[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]