获得性肝性脑部变性的MRI表现

目的探讨获得性肝性脑部变性的MRI影像学特征及原因。方法对23例有精神神经症状的慢性肝硬化患者进行头颅MRI扫描,其中1例并行增强扫描,4例同时进行腹部扫描,分析其MRI征象。结果23例患者,22例脑部MRI有阳性发现,1例MRI表现阴性。双侧苍白球(22/22),豆状核(13/22),红核(9/22),垂体前叶(7/22),大脑脚盖(2/22)在自旋回波(SE)序列T1WI表现为高信号,快速自旋回波(FSE)T2WI信号正常,病灶区脑结构的体积、形态无变化。结论双侧基底节等部位出现T1WI高信号是获得性肝性脑部变性较为特征性的影像学表现,结合临床慢性肝硬化病史可确定诊断。

Acquired Hepatocerebral Degeneration:MRI Features of Brain

Objective To investigate MRI characteristics and etiology of acquired hepatocerebral degeneration.Methods 23 patients with chronic hepatic cirrhosis and the symptoms of psychosis were examined by brain MR scan,one of them underwent contrast-enhanced MR scan,and abdominal MR scan was performed in 4 cases,the results were analyzed.Results Cerebral abnormalities were found in 22 patients.MRI findings included:high signal intensity in bilateral globus pallidus(22/22),lentiform nucleus(13/22),red nucleus(9/22),anterior pituitary(7/22),and tegmenti of cerebral peduncles(2/22),on T1WI and normal on T2WI,the volume and shape of cerebral structures involved by lesions were unchanged.Conclusion Chronic hepatic cirrhosis is characterized by abnormal increases of signal!intensity on T1WI in certain region(such as bilateral basal ganglia).MRI is sensitive to detect such lesion.