MRI诊断获得性肝性脑部变性的价值

目的:探讨获得性肝性脑部变性(AHCD)的脑部MRI表现特征,评价MRI对AHCD的诊断价值。方法:对18例经临床确诊为肝性脑病患者进行头颅MRI扫描,其中3例行增强扫描,4例同时行腹部MRI扫描,分析其MRI征象。结果:18例患者脑部MRI扫描均有阳性发现,主要显示基底节区信号强度对称性增高,双侧豆状核(18/18),中脑红核周围(16/18),垂体前叶(10/18)快速自旋回波(FSE)T1WI均表现为高信号,FES T2WI信号正常17例,高信号1例。18例T2FLAIR信号正常。病变区脑结构的体积、形态无变化。结论:MRI T1WI双侧基底节、中脑等部位出现高信号影,是AHCD较为特征性的影像学表现,MRI是发现这些病变最敏感的方法。

The cerebral MRI findings in patients with acquired hepatocerebral degeneration

Objective：To explore the MRI characteristics of acquired hepatocerebral degenerations（AHCD） and to evaluate MRI diagnostic values for this disorder. Methods：18 patients with hepatic encephalopathy confirmed by clinic were examined by brain MR scan and MRI findings were analyzed,3 of them underwent contrast-enhanced MR scan and abdominal MR scan was performed in 4 cases.Results：All the 18 patients had cerebral abnormal MRI findings and mainly showed symmetrical high signal in basal ganglia,including hyperintense on T1WI（FSE） in bilateral lentiform nucleus（18/18）,surroundings of mesocerebrum and red nucleus（16/18）,anterior pituitary（10/18）;normal（17/18） and hyperintense（1/18） on T2WI,normal（18/18） on T2FLAIR.The volume and shape of cerebral structures involved by lesions were unchanged.Conclusion：AHCD is characterized by hyperintense on T1WI in certain regions,such as bilateral basal ganglia and mesocerebrum.MRI is sensitive to detect such lesions.