轻微肝性脑病的MRI与^1H-MRS探讨

目的探讨轻微肝性脑病患者颅脑MRI及^1H-MRS的代谢变化。方法 22例经神经心理测试诊断为轻微肝性脑病患者和13例年龄、性别和受教育程度相匹配的健康志愿者,行MRI、^1H-MRS扫描,^1H-MRS兴趣区为双侧基底节。结果 22例患者中17例双侧基底节在T1WI上可见高信号,NAA/Cr值患者组与健康对照组之间差异无显著性（P〉0.05）,而mI/Cr和Cho/Cr值患者组与健康对照组比较显著降低（L：P〈0.01;R：P〈0.01）。结论 T1WI高信号是诊断轻微肝性脑病较为特征性征象,1HMRS能够无创性观察到轻微肝性脑病患者的脑代谢异常,有助于揭示肝性脑病的病理生理机制。

The value of MRI and 1H - MRS in patients with minimal hepatic encephalopathy

Objective To investigate the signal changes and metabolic alterations in the brain by using MRI and proton magnetic resonance spectroscopy（^1H-MRS） in patients with minimal hepatic encephalopathy （MHE）. Methods 22 patients with MHE were diagnosed by neuropsychological tests. MRI plain scan and ^1H-MRS were performed for the patients and 13 age and education matched healthy controls. Localized magnetic resonance spectra were acquired in the bilateral basal ganglia. Results Bilateral symmetrical hyper intensity in basal ganglia was detected in 17 of the patients. NAA/Cr levels had no significant difference between the patients and healthy controls （P〉0.05）. The ratios of mI/Cr and Cho/Cr of the bilateral basal ganglia were significantly reduced in MHE patients（L：P〈0.01;R： P〈0.01）. Conclusion Signal hyper intensities and the mI/Cr and Cho/Cr ratios measured in the basal ganglia correlated significantly with the MHE. MRI and ^1H-MRS in basal ganglia play a significant role in the pathophysiology of MHE.