静息态功能磁共振分析轻微型肝性脑病不同脑区的功能变化  

Analysis of Functional Changes in Different Brain Regions of Minimal Hepatic Encephalopathy by Resting-state Functional Magnetic Resonance Imaging

作　　者：梁斌 温志波[1] Liang Bin;Wen Zhi-bo(Department of Imaging,zhujiang hospital,Southern Medical University,Guangzhou 510000,Guangdong Province,China;Department of Imaging,Lecong Hospital,Shunde District,Foshan City,Foshan 528000,Guangdong Province,China)

机构地区：[1]南方医科大学珠江医院影像科,广东广州510000 [2]佛山市顺德区乐从医院影像科,广东佛山528000

出　　处：《中国CT和MRI杂志》2024年第2期32-35,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨静息态功能磁共振(rs-fMRI)分析轻微型肝性脑病(MHE)不同脑区的功能变化。方法选取2017年2月~2022年5月于本院就诊的88例肝硬化患者作为研究对象,根据是否发生MHE分为MHE组(n=45)和非MHE组(n=43),并选取同期在本院进行体检的健康人员(n=50)作为对照组。通过倾向性评分匹配(PSM)法按照1:1:1匹配后三组各为40例,比较三组受试者的一般资料。受试者均行头颅rs-fMRI扫描,采用统计学方法分析比较三组受试者全脑不同脑区的功能连接(FC)。分析三组受试者认知功能评分情况。Spearman相关性检验分析肝硬化患者认知功能评分与FC改变的相关性。结果与对照组相比,MHE组双侧中央后回、双侧楔叶/枕上小叶、左侧枕中回、左侧盖部额下回以及右侧舌回FC明显降低,差异具有统计学意义(P<0.05)。与对照组相比,MHE组数字连接试验(NCT-A)测试结果更高(P<0.05),数字符号试验(DST)评分更低(P<0.05)。NCT-A与DST量表评分与双侧楔叶/枕上小叶、左侧盖部额下回以及左侧颞上回的FC改变均呈显著负相关(P<0.05)。结论若肝硬化患者伴有MHE,双侧中央后回、双侧楔叶/枕上小叶、左侧枕中回、左侧盖部额下回以及右侧舌回FC存在异常,会出现认知功能障碍,其认知功能障碍可能与不同脑区FC改变有关。Objective To investigate the functional changes of different brain regions in minimal hepatic encephalopathy(MHE)by resting-state functional magnetic resonance imaging(fMRI).Methods A total of 88 patients with liver cirrhosis who were treated in our hospital from February 2017 to May 2022 were selected as the research objects.According to the occurrence of MHE,they were divided into MHE group(n=45)and non-MHE group(n=43),and healthy people who underwent physical examination in our hospital during the same period(n=50)were selected as the control group.The propensity score matching(PSM)method was used to match the three groups according to 1:1:1,with 40 cases in each group.The general data of the three groups were compared.All subjects underwent rs-fMRI scan,and the functional connectivity(FC)of different brain regions in the whole brain of the three groups was analyzed and compared by statistical methods.The cognitive function scores of the three groups were analyzed.Spearman correlation test was used to analyze the correlation between cognitive function score and FC changes in patients with cirrhosis.Results Compared with the control group,the FC of bilateral postcentral gyrus,bilateral cuneus/superior occipital lobule,left middle occipital gyrus,left inferior frontal gyrus and right lingual gyrus in MHE group were significantly lower(P<0.05).Compared with the control group,the NCT-A test results of the MHE group were higher(P<0.05),and the DST scores were lower(P<0.05).The scores of NCT-A and DST scales were significantly negatively correlated with FC changes in bilateral cuneus/superior occipital lobule,left inferior frontal gyrus and left superior temporal gyrus(P<0.05).Conclusion If patients with cirrhosis have MHE,bilateral postcentral gyrus,bilateral cuneus/occipital lobule,left middle occipital gyrus,left opercular inferior frontal gyrus and right lingual gyrus have abnormal FC,cognitive dysfunction will occur.Cognitive dysfunction may be related to FC changes in different brain regions.

关 键 词：静息态功能磁共振 轻微型肝性脑病 脑区 功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.1[医药卫生—诊断学]