Neuropsychiatric profile and hyperintense globus pallidus on T1-weighted magnetic resonance images in liver cirrhosis
Neuropsychiatric profile and hyperintense globus pallidus on T1-weighted magnetic resonance images in liver cirrhosis
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DOI：
10.1053/gast.1996.v111.pm8698193
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发表时间：
1996-07-01
期刊：
影响因子：
29.4
通讯作者：
Krieger, D
中科院分区：
文献类型：
--
作者：
Krieger, S;Jauss, M;Krieger, D
背景和目标：据报道，肝硬化患者T1加权磁共振成像（MRI）上的高信号苍白球可反映肝脏疾病的严重程度;然而，其对肝性脑病的影响尚不清楚。本研究的目的是概述慢性肝功能衰竭的神经精神异常模式及其与MRI结果的相关性。方法：51例连续患者入组研究。神经精神评估采用标准化方案，包括二分神经学参数、简要精神病评定和心理测量测试以及脑电图。使用标准实验室参数和Child-Pugh分级对肝功能衰竭的严重程度进行分级。苍白球的信号强度在矢状位T1加权MRI上确定。结果如下：主成分分析可以区分两个方面的神经功能障碍：复杂的大脑功能和皮层下运动性能的损害。这两种神经系统分类与肝功能衰竭的严重程度、脑电图异常的分级和心理测试结果相关。此外，先前发作的明显脑病表明进行性痴呆。T1加权苍白球信号强度与任何临床或实验室检查结果无关。结论：这项研究显示了肝衰竭和T1加权MRI上苍白球高信号患者的神经系统表现的特征性模式。虽然神经功能障碍与肝功能衰竭相似，但基底节MRI异常并不能表明实际肝性脑病的严重程度。
Background & Aims: Hyperintense globus pallidus on T1-weighted magnetic resonance images (MRIs) in cirrhotic patients are reported to reflect severity of liver disease; however, their consequence for hepatic encephalopathy is unknown. The aim of this study was to outline a pattern of neuropsychiatric abnormalities in chronic liver failure and its correlation with MRI findings. Methods: Fifty-one consecutive patients were enrolled in the study. Neuropsychiatric assessment used a standardized protocol, including dichotomized neurological parameters, brief psychiatric rating and psychometric tests, as well as electroencephalography. The severity of liver failure was graded using standard laboratory parameters and the Child-Pugh's classification. Signal intensity of the globus pallidus was determined on sagittal T1-weighted MRIs. Results: Two aspects of neurological dysfunction could be distinguished by principal components analysis: impairment of complex cerebral function and subcortical motor performance. Both neurological categories correlated with severity of liver failure, grade of electroencephalographic abnormalities, and psychometric test results. Additionally, prior bouts of overt encephalopathy indicate progressive dementia. T1-weighted globus pallidus signal intensity did not correlate with any clinical or laboratory test result. Conclusions: This study shows a characteristic pattern of neurological findings in patients with liver failure and hyperintense globus pallidus on T1-weighted MRIs. Although neurological dysfunction parallels hepatic failure, MRI abnormalities of basal ganglia do not indicate severity of actual hepatic encephalopathy.