基于脑皮层厚度分析在肝性脑病结构改变的研究  

Abnormal Brain Structure in Hepatic Encephalopathy:Morphology-Based Cortical Thickness Analysis

作　　者：周治明[1] 赵建农[1] 王康程 石江勇 ZHOU Zhiming ZHAO Jiannong WANG Kangcheng et al(Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China)

机构地区：[1]重庆医科大学附属第二医院放射科,400010 [2]西南大学心理学部,400700

出　　处：《临床放射学杂志》2017年第2期171-175,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81071126)

摘　　要：目的探讨不同阶段肝性脑病(HE)患者皮层厚度改变情况。方法搜集22例症状型HE(SHE)患者(SHE组)、20例轻微型HE(MHE)患者(MHE组)、25例无肝性脑病肝硬化患者(NMHE组)和27例健康对照者(HC组)行MRI扫描并获取T_1-3D全脑高分辨结构图,采用Freesurfer软件计算皮层厚度,对比分析患者组与HC组皮层厚度差异及SHE组皮层厚度与血氨的相关性分析。结果对比HC组,SHE组在左侧岛环状沟上份、中后扣带回、左侧楔前叶、左侧侧副沟和舌沟、右侧中央前沟下份、右侧颞上回、右侧侧副沟和舌沟区域皮层厚度降低;MHE组在右侧中央前沟下份区域皮层厚度降低;NMHE组在左侧额下沟区域皮层厚度降低(P<0.05)。结论SHE组、MHE及NMHE患者大脑多个区域皮层厚度存在异常,并随着HE发展进程中表现出皮层改变区域逐渐增多趋势。Objective To explore the changes of cortical thickness in patients with different stages of hepatic encephalopathy（ HE）. Methods A total of 22 patients with symptomatic HE（ SHE group）,20 patients with minimal HE（ MHE group）,25 cirrhotic patients without hepatic encephalopathy（ NMHE group） and 27 healthy contrasts（ HC group） underwent magnetic resonance imaging（ MRI） and the 3D high-resolution T1 weighted brain structural MRI data was acquired.Using the Freesurfer software,the cortical thickness was calculated for statistical analysis between patients and controls,and correlation between blood ammonia level and cortical thickness in the SHE group was computed by Pearson correlation analysis. Results Compared with the HC group,the cortical thickness decreased in the left superior segment of the circular sulcus of the insula,left middle-posterior part of the cingulate gyrus and sulcus,left precuneus,double medial occipitotemporal sulcus and lingual sulcus,right inferior part of the precentral sulcus,right superior temporal sulcus in the SHE group and in the right inferior part of the precentral sulcus in the MHE group as well as in the left inferior frontal sulcus in the NMHE group separately（ all P 〈 0. 05）. Conclusion The abnormality of cortical thickness exists in the related cortical regions of patients with HE and NMHE,and with the HE the development of HE,the abnormal cortical regions show the tendency of gradually increasing.

关 键 词：皮层厚度 肝性脑病 磁共振成像 FREESURFER 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.3[医药卫生—诊断学]