摘要
目的 描述获得性肝性脑部变性的脑部MR表现 ,评价MR对该病的诊断价值。方法对 2 6例 (男 17例 ,女 9例 )各种原因引起的慢性肝病肝功能衰竭患者进行了脑部MR检查 ,8例同时进行了腹部MR数字减影血管造影 (MRDSA)。其中 2 5例在MR检查后 2周内测定血氨水平并对血氨水平与信号强度做统计学分析。结果 2 6例中 2 2例脑部有阳性发现 ,表现为自旋回波 (SE)序列双侧苍白球 (2 2 / 2 6 )、豆状核 (4 / 2 6 )、中脑红核周围 (15 / 2 6 )、脑垂体前叶 (12 / 2 6 )等部位T1WI对称的高信号 ,快速自旋回波 (TSE)序列T2 WI无异常信号。 8例MRDSA均显示了明显的门 体静脉分流的存在。统计学分析表明 ,血氨水平与脑内异常信号的信号强度之间呈显著性正相关 (相关系数r=0 5 12 6 ,P <0 0 1)。结论 T1WI上苍白球豆状核、中脑红核周围、垂体出现的高信号是各种原因引起的慢性肝功能衰竭的较为特征性的征象 ,表明脑部变性的存在。MRDSA的应用可发现门 体静脉分流的存在 。
Objective To describe the MRI findings in patients with Acquired hepatiocerbral Degeneration(AHCD) and evaluate the role of MRI in dignosis of AHCD. Methods 26 patients with chornic hepatic failure under went brain MRI scan. Eight of these patients had abdominal MR digital subtract angiography(MRDSA) examnation. 25 patients had plasma ammonia levels test two weeks after MR exmnation. Results 22 patients had abnormal MRI findings, T 1WI demonstrated incresed signal in the globus pallidus (22/26), putmen (4/26), mesencephalon surrounding red nucleus(15/26),and in the anterior pituitary (12/26). While T 2WI demonstraied no corresponding alteration in signal intensity. Eight patients which had MRDSA showed obvious portal systemic shunts. There was positive correlation between plasam ammonia level and abnormal signal( r = 0.521 6, P <0.01). Conclusion Abnormal MR signals in the brain is seen in most patients with chronic hepatic failure, MRI is a sensitive method to detect such lesions,MRDSA can demonstrate the presence of portal sysmetic shunt .
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2000年第12期841-843,共3页
Chinese Journal of Radiology
关键词
肝性脑病
磁共振成像
获得性肝性脑部变性
Hepatic encephalopathy
Magnetic resonance imaging
Liver cirrhosis
