轻微型肝性脑病的扩散张量成像研究  

Diffusion tensor imaging study of minimal hepatic encephalopathy

作　　者：王建萍 汪涛 戚乐[1] 潘磊 WANG Jian-ping;WANG Tao;QI Ie;PAN Lei(Department of Radiology,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Department of Radiology,Hangzhou Geriatric Hospital,Hangzhou 310022,China)

机构地区：[1]杭州师范大学附属医院放射科,浙江杭州310015 [2]杭州市老年病医院放射科,浙江杭州310022

出　　处：《中国临床医学影像杂志》2021年第5期310-314,共5页Journal of China Clinic Medical Imaging

基　　金：杭州市卫生科技计划一般(A)类项目(2017A14);浙江省医药卫生一般研究计划项目(2018KY587);杭州市农业与社会发展科研自主申报项目(20191203B101)。

摘　　要：目的:运用磁共振扩散张量成像(DTI)基于纤维束示踪的空间统计分析(TBSS)方法研究轻微型肝性脑病(MHE)患者脑白质纤维的改变。方法:对23例轻微型肝性脑病患者(实验组)和25例健康志愿者(对照组)进行全脑DTI扫描。运用FSL软件解算全脑白质各向异性分数(FA)和平均扩散系数(MD),通过TBSS方法比较两组间差异。提取有差异脑区的FA值、MD值与NCT-A时间、DST评分进行Pearson相关性分析。结果:与正常对照组相比,实验组FA值降低(P<0.005)的区块数为5,受累纤维束包括胼胝体、双侧皮质脊髓束、双侧丘脑前辐射、左侧扣带回及左侧上纵束,MD值增加(P<0.005)的区块数为5,受累纤维束包括胼胝体、双侧丘脑前辐射、左侧皮质脊髓束、双侧下额枕束、上纵束及勾状束。胼胝体及右侧皮质脊髓束FA值与DST评分呈正相关(r=0.46,P<0.05;r=0.54,P<0.01)。结论:基于TBSS的DTI可以敏感地发现MHE患者脑白质纤维束的损害,对于提示MHE的早期脑细微结构变化具有重要意义。Objective:To explore the change of fiber bundles of white matter in minimal hepatic encephalopathy(MHE)patients by using diffusion tensor imaging(DTI)based on the tract-based spatial statistics(TBSS).Methods:DTI scan was acquired on 23 MHE patients and 25 healthy controls.FSL software was used to calculate fractional anisotropy(FA)and mean diffusivity(MD),which were compared between the two groups using TBSS.Correlation analysis was used to explore the relationship between FA(MD)values and NCT-A(DST)results.Results:Compared with the healthy group,the number of blocks which showed decreased FA values(P<0.005)in the MHE is 5,the affected fiber bundles include corpus callosum,bilateral corticospinal tract,bilateral anterior thalamic radiation,left cingulate gyrus and left superior longitudinal fasciculus;the number of blocks which showed increased MD values(P<0.005)is also 5,the affected fiber bundles include corpus callosum,anterior thalamic radiation,left corticospinal tract,bilateral inferior fronto-occipital fasciculus,longitudinal fasciculus and uncinate fasciculus.Pearson correlation analysis showed that the FA values of right corticospinal tract and corpus callosum were positively correlated with the DST scores.Conclusion:TBSS could determine the damage of white matter fiber bundles in MHE,and it is of great significance to indicate the changes of early brain microstructure of MHE.

关 键 词：肝性脑病 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]