磁共振成像2018，Vol.9Issue(1)：21-26,6.DOI:10.12015/issn.1674-8034.2018.01.005
乙肝后肝硬化患者局灶性脑白质高信号与轻微型肝性脑病相关性的MRI研究
Relationship between focal white matter hyperintensity and minimal hepatic encephalopathy in patients with hepatitis B virus-related cirrhosis
摘要
Abstract
Objective: To explore the relationship between focal white matter hyperintensity (WMH) and minimal hepatic encephalopathy (MHE) in patients with hepatitis B virus-related cirrhosis. Materials and Methods: Thirty-eight patients with hepatitis B virus-related cirrhosis, including 20 nHE and 18 MHE, admitted to our institution were included prospectively. All patients underwent neuropsychological tests, blood biochemical determinations and cerebral magnetic resonance imaging. Fluid attenuated inversion recover (FLAIR) images were reviewed for focal WMH by two neuroradiologists, independently. Those with Fazekas scale scores 0-1 were classified as no or mild focal WMH, while those with Fazekas scale scores≥2 were classified as moderate or severe focal WMH. nHE and MHE groups were compared concerning age, gender, duration of cirrhosis, Child-Pugh scale, venous blood ammonia level and the severity of focal WMH. Multivariate logistic regression analysis was performed to evaluate the independent predictor for MHE. The Spearman rank tests were performed to investigate correlation between the severity of focal WMH and cognitive function. Results: Cpmpared with the age and gender-matched nHE group, there were significantly more patients with moderate or severe focal WMH in MHE group (P<0.01). However, duration of cirrhosis, Child-Pugh scale and venous blood ammonia level did not differ significantly between the two groups (all P>0.05). Multivariate logistic regression analysis showed that moderate or severe focal WMH was the independent predictor for MHE (OR=18.62, 95％ CI: 2.43—142.86, P<0.05). Correlation analyses showed significant positive correlation between the severity of focal WMH and completion time of NCT-A (r=0.617, P<0.01), significant negative correlations between the severity of focal WMH and scores of DST and digital span test (r=-0.695, P<0.01, r=-0.558, P<0.01). Conclusions: Moderate or severe focal WMH in cirrhotic patients is the independent predictor for MHE, which indicates the possibility of MHE.关键词
肝性脑病/磁共振成像Key words
Hepatic encephalopathy/Magnetic resonance imaging分类
医药卫生引用本文复制引用
郑薇,冯智超,朱文卫,李利丰,廖云杰,梁琪,王维..乙肝后肝硬化患者局灶性脑白质高信号与轻微型肝性脑病相关性的MRI研究[J].磁共振成像,2018,9(1):21-26,6.基金项目
This work was part of project of Natural Science Foundation of Hunan Province (No. 2016JJ6149).湖南省自然科学基金项目(编号:2016JJ6149) （No. 2016JJ6149）
