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目的探讨不同阶段肝性脑病(HE)患者皮层厚度改变情况。方法搜集22例症状型HE(SHE)患者(SHE组)、20例轻微型HE(MHE)患者(MHE组)、25例无肝性脑病肝硬化患者(NMHE组)和27例健康对照者(HC组)行MRI扫描并获取T_1-3D全脑高分辨结构图,采用Freesurfer软件计算皮层厚度,对比分析患者组与HC组皮层厚度差异及SHE组皮层厚度与血氨的相关性分析。结果对比HC组,SHE组在左侧岛环状沟上份、中后扣带回、左侧楔前叶、左侧侧副沟和舌沟、右侧中央前沟下份、右侧颞上回、右侧侧副沟和舌沟区域皮层厚度降低;MHE组在右侧中央前沟下份区域皮层厚度降低;NMHE组在左侧额下沟区域皮层厚度降低(P<0.05)。结论SHE组、MHE及NMHE患者大脑多个区域皮层厚度存在异常,并随着HE发展进程中表现出皮层改变区域逐渐增多趋势。
Objective To investigate the changes of cortical thickness in patients with hepatic encephalopathy (HE) at different stages. Methods Twenty - two patients with SHE (SHE), 20 patients with mild type HE (MHE), 25 patients without hepatic encephalopathy (NMHE) and 27 healthy controls HC group). The whole brain of T_1-3D was obtained by MRI scanning. The thickness of cortex was calculated by Freesurfer software. The difference of cortical thickness between HC and HC group and the correlation between cortical thickness and blood ammonia in SHE group were analyzed. Results Compared with the HC group and the SHE group, the left lobe ring ditch, middle and posterior cingulate gyrus, left wedge anterior lobe, left lateral lobe and tongue groove, right lateral anterior lobe, right temporal superior In the MHE group, the cortical thickness in the lower part of the right central anterior sulcus decreased. In the NMHE group, the cortical thickness of the lower frontal sulci decreased (P <0.05). Conclusions There is an abnormality in the cortex thickness of multiple regions of brain in patients with SHE, MHE and NMHE, and the area of cortical changes gradually increases with the development of HE.