轻微型肝性脑病患者大脑半球间镜像连接的静息态fMRI研究  

Interhemispheric functional connectivity in minimal hepatic encephalopathy:a voxel-mirrored homotopic connectivity fMRI study

作　　者：邱翔 李婷[2] 唐玉莲 彭娟 刘勇 QIU Xiang;LI Ting;TANG Yulian;PENG Juan;LIU Yong(Department of Radiology,Chendu Integrated TCM&Western Medicine Hospital,Chendu First People's Hospital,Chendu 610041,P.R.China;Department of Radiology,North Sichuan Medical College Affiliated Hospital,Nanchong 637000,P.R.China;Department of Radiology,Sichuan Provincial People’s Hospital Jinniu Hospital,Chengdu 610000,P.R.China)

机构地区：[1]四川省成都市中西医结合医院成都市第一人民医院放射科,四川成都610041 [2]川北医学院附属医院放射科,四川南充637000 [3]四川省人民医院金牛医院放射科,四川成都610000

出　　处：《医学影像学杂志》2020年第9期1553-1557,共5页Journal of Medical Imaging

摘　　要：目的探讨轻微型肝性脑病患者大脑半球间镜像功能连接变化,并讨论部分脑区变化与神经心理测试评分、肝功能Child-Pugh分级关系。方法采用静息态fMRI扫描及DPABI软件计算26例轻微性肝性脑病(MHE组)和24例健康志愿者(HC组)镜像同伦功能连接(VMHC)差异,并分析VMHC与数字-符号试验(DST)、数字连接试验-A(NCT-A)、肝功能Child-Pugh分级之间的相关性。结果MHE组较HC组VMHC降低的脑区包括双侧额中回、双侧岛叶、双侧颞上回、角回、缘上回(P<0.05,GRF校正)。MHE组VMHC值在双侧额中回与NCT-A呈显著正相关(r=0.394,P<0.05)。结论MHE患者双侧大脑半球间存在信息交流障碍,这种变化与不同的临床症状有关,且双侧额中回VMHC连接强度可能提示MHE患者认知状态。Objective To investigate the resting-state functional connectivity between the two hemispheres in minimal hepatic encephalopathy(MHE)using voxel-mirrored homotopic connectivity(VMHC)based on resting state functional MRI(fMRI),and to explore the significant relevant of abnormality in brain with neuropsychological test scores and liver function Child-Pugh grading.Methods Twenty-six MHE patients and 24 healthy volunteers matched for age and sex underwent resting-state fMRI scans in a 3.0 T scanner.The data were processed by DPABI software.The VMHC values between the two groups were compared by two-sample t-test.The statistical map with significant differences of VMHC value was obtained.Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and then,we extracted the value of VMHC in these significant regions and applied correlation analysis to explore whether neuropsychological test scores and liver function Child-Pugh grading were significant relevant with the above values.Results Compared to the controls,patients showed significant VMHC decreases in the bilateral middle frontal gyrus,and insula,superior temporal gyrus,angular gyrus,superior marginal gyrus(P<0.05,GRF corrected).VMHC was positively correlated with the bilateral middle frontal gyrus(r=0.394,P<0.05).Conclusion The functional coordination between homotopic brain regions is impaired in MHE patients,which is related to different clinical symptoms,and the intensity of VMHC connection in the bilateral middle frontal gyrus can be indicators to evaluate the cognitive function of MHE patient.

关 键 词：轻微型肝性脑病 磁共振成像 静息态磁共振脑功能成像 镜像同伦功能连接 

分 类 号：R749.2[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]