肝性脑病患者的EEG、CT和MRI研究

目的 描述肝性脑病患者的临床表现及脑电图(EEG)、颅脑CT、MRI特点,评价EEG、CT、MRI对该病的诊断价值.方法 总结17例各种原因引起的肝性脑病患者的临床表现、血氨水平,对全部病例进行EEG、颅脑CT、MRI检查.结果 17例肝性脑病患者EEG异常15例,主要表现为:基本节律慢化;中波～高波幅θ活动;散在的δ波、三相波.MRI检查阳性14例,主要特点为双侧苍白球(14/17)、豆状核(4/17)、中脑被盖(7/17)T1WI高信号,T2WI等信号,T2FLAIR序列可见大脑半球白质区双侧对称性高信号.CT检查在同一部位未见异常信号.结论 肝性脑病患者EEG、颅脑CT和MRI检查各具有特征性,可为临床诊断提供重要信息.

EEG, CT and MRI findings in hepatic encephalopathy

OBJECTIVE: To describe the clinical manifestation and the EEG, CT and MRI findings of hepatic encephalopathy (HE). METHODS: The clinical manifestations and the plasma ammonia levels were analyzed in 17 patients with HE, who underwent EEG, CT and MRI examinations. RESULTS: Fifteen patients had abnormal EEG findings characterized by lowered basic rhythm, moderate to high amplitude theta wave activity, and sporadic delta wave and triphasic wave. Fourteen patients had abnormal MRI findings, including increased signal in the bilateral globus pallidus (14/17), putmen(4/17) and tegmentum of the midbrain (7/17) in T1WI without corresponding alterations in the signal intensity in T2WI. T2 FLAIR demonstrated increased signal in the bilateral white matter of the cerebral hemispheres. CT identified no corresponding alterations in the signal intensity. CONCLUSION: Abnormal EEG findings or MR signals in the brain are common in patients with HE. EEG allows detection of abnormal waves, and MRI may help identify such lesions, which all help in the diagnosis of HE.