摘要
目的采用静息态功能MRI(rs-fMRI)联合扩散张量成像(DTI)探讨慢性乙肝肝硬化患者(HBV-RC)全脑功能连接(FC)、白质结构连接(SC)随疾病进展的演变规律,及其与肝性脑病心理测量(PHES)评分之间的关系。方法前瞻性分析2011年4至10月在广东省第二人民医院就诊的30例HBV-RC患者的资料,其中肝硬化合并轻微肝性脑病13例(MHE组)、肝硬化无肝性脑病17例(NMHE组),另同期纳入与HBV-RC患者年龄、性别和受教育程度相匹配的健康人38名(HC组)。采集所有受试者的rs-fMRI、DTI数据和PHES评分。使用Gretna工具包和PANDA工具包分别对rs-fMRI和DTI数据进行预处理并构建功能和结构网络。采用基于网络的统计方法(NBS)比较3组被试功能网络和结构网络的差异,采用Spearman相关性分析评估功能网络和结构网络的异常与PHES评分之间的相关性,采用结构方程模型分析FC、SC、PHES三者之间的关系。结果与HC组相比,肝硬化患者从NMHE到MHE阶段,其功能网络和结构网络均表现为渐进性破坏,主要分布于认知控制网络、默认网络以及边缘网络(P<0.01,NBS矫正)。HBV-RC患者功能网络和结构网络的破坏与其PHES评分具有显著负相关性(P<0.05,错误发现率矫正)。结构方程模型结果证实HBV-RC患者功能网络的破坏介导了其结构网络破坏与患者认知功能下降的关系(P<0.05)。结论HBV-RC患者功能网络和结构网络均表现为随疾病进展的渐进性破坏,并与PHES评分显著相关。此外,HBV-RC患者功能网络的破坏介导了其结构网络的破坏与患者认知功能障碍的关系。
Objective To explore the disease-related impairment of functional and structural connectivity network and their relationship with psychometric hepatic encephalopathy score(PHES)in patients with chronic hepatitis B virus-related cirrhosis(HBV-RC)by combining resting-state functional MRI(rs-fMRI)and diffusion tensor imaging(DTI).Methods Data of 30 HBV-RC patients[including 13 HBV-RC patients with minimal hepatic encephalopathy(MHE)and 17 HBV-RC patients without MHE(NMHE)]from April 2011 to October 2011 in Guangdong No.2 People′s Hospital were analyzed prospectively,and 38 healthy individuals matched for age,sex,and education with HBV-RC patients(HC group)were included during the same period.Rs-fMR and DTI data as well as PHES data of all participants were collected.Gretna and PANDA software package were used to preprocess the imaging data and construct the functional and structural network respectively.The network-based statistic(NBS)approach was used to compare the differences of the functional and structural connections among three groups.Spearman′s correlation analysis was used to identify the relationship between functional or structural connectivity and PHES.The structural equation modeling(SEM)was used to explore the relationships among functional connectivity,structural connectivity,and PHES.Results Compared to HC group,both functional and structural connectivity in the whole brain progressively destroyed from NMHE to MHE,mainly involving cognitive control network,default mode network,and limbic network(NBS corrected,all P<0.01).There were significantly negative relationships between functional or structural connectivity and PHES in HBV-RC patients(false discovery rate corrected,all P<0.05).The SEM results showed the influence of structural connectivity on neurocognitive impairment was mediated by functional connectivity(P<0.05).Conclusion Both functional and structural networks progressively destroy in HBV-RC patients as the disease advanced and these alterations significantly correlate with PHES.Beside
作者
林仕伟
陈胜利
林晓珊
邱迎伟
Lin Shiwei;Chen Shengli;Lin Xiaoshan;Qiu Yingwei(Department of Radiology,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518000,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2022年第12期1339-1346,共8页
Chinese Journal of Radiology
基金
国家自然科学基金(81560283,81201084)
广东省自然科学基金(2020A1515011332)。
关键词
肝硬化
肝性脑病
磁共振成像
神经网络
Liver cirrhosis
Hepatic encephalopathy
Magnetic resonance imaging
Neural networks
