Iwasa Motoh, Matsumura Kaname, Nakagawa Yuri, Yamamoto Mika, Tanaka Hideaki, Horiike Shinichiro, Ikoma Jiro, Kaito Masahiko, Takeda Kan, Adachi Yukihiko
Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Metab Brain Dis. 2005 Mar;20(1):7-17. doi: 10.1007/s11011-005-2472-3.
Although neuropsychological tests are commonly applied to detect minimal hepatic encephalopathy (HE) in patients with liver cirrhosis (LC), they provide no information about the cerebral regions involved. Recently, it has been reported that some populations of alcoholic cirrhotics, with mild HE, have reduced cerebral metabolic rate for glucose in bifrontal cortices and in the anterior cingulate gyrus. We evaluated the degree of reduction in blood flow at the anterior cingulate gyrus and the frontal lobes in cirrhotic patients who underwent single photon emission computed tomography (SPECT). Data were obtained from 47 cirrhotic patients and 47 subjects without LC. Three radiologists unaware of the results of laboratory tests visually evaluated the transaxial, coronal, and sagittal views of SPECT. The area and the degree of blood flow reduction in the anterior cingulate gyrus and frontal lobes were scored. Reduced blood flow in the anterior cingulate gyrus was observed in most LC patients. In patients without overt HE, poor performance in neuropsychological tests was correlated with reduced cerebral blood flow in the anterior cingulate gyrus. Blood flow in the anterior cingulate gyrus as measured by SPECT may be a simple and good indicator of cerebral functional changes in patients with LC.
尽管神经心理学测试常用于检测肝硬化（LC）患者的轻微肝性脑病（HE），但这些测试无法提供有关受累脑区的信息。最近有报道称，一些患有轻度HE的酒精性肝硬化患者，其双额叶皮质和前扣带回的脑葡萄糖代谢率降低。我们评估了接受单光子发射计算机断层扫描（SPECT）的肝硬化患者前扣带回和额叶的血流减少程度。数据来自47例肝硬化患者和47例无LC的受试者。三位不了解实验室检查结果的放射科医生对SPECT的轴向、冠状和矢状视图进行了视觉评估。对前扣带回和额叶的血流减少面积和程度进行评分。大多数LC患者观察到前扣带回血流减少。在没有明显HE的患者中，神经心理学测试表现不佳与前扣带回脑血流减少相关。通过SPECT测量的前扣带回血流可能是LC患者脑功能变化的一个简单且良好的指标。
