Department of Psychological Medicine, Shimane University School of Medicine, 89-1 Enyacho, Izumo, Japan.
Aust N Z J Psychiatry. 2009 Nov;43(11):1057-69. doi: 10.3109/00048670903107526.
The purpose of the present study was to examine whether patients with idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome; GS) have specific changes in signal intensity on magnetic resonance imaging (MRI).
Axial 5 mm-thick T1-weighted and T2-weighted MRI was acquired from schizophrenia patients with GS (n = 24) and schizophrenia patients without GS (n = 60). All patients were diagnosed according to DSM-IV criteria and were compared with age- and sex-matched healthy controls without GS (n=60) and controls with GS (n=36). Signal intensity in the hippocampus, amygdala, caudate, putamen, globus pallidus, thalamus, anterior cingulate gyrus, posterior cingulate gyrus, insular cortex, and cerebellum was measured in relation to the signal intensities of the vitreous body.
Compared to both schizophrenia patients without GS and the control subjects without or with GS, the schizophrenia patients with GS had significantly decreased signal intensity in almost all the regions measured on T1-weighted MRI. On T2-weighted MRI, the schizophrenia patients with GS had significantly increased signal intensity in almost all the regions measured compared to both schizophrenia patients without GS and the control subjects without or with GS.
Patients with schizophrenia-associated GS have specific changes in signal intensity on T1- and T2-weighted MRI, suggesting that schizophrenia with GS produces changes specifically in the frontotemporal cortex, limbic system, and basal ganglia.
本研究旨在探讨特发性非结合性高胆红素血症(吉尔伯特综合征;GS)患者的磁共振成像(MRI)信号强度是否存在特异性变化。
对 24 例 GS 伴精神分裂症患者和 60 例无 GS 的精神分裂症患者进行了轴位 5mm 厚 T1 加权和 T2 加权 MRI 扫描。所有患者均根据 DSM-IV 标准诊断,并与年龄和性别匹配的无 GS 的健康对照组(n=60)和无 GS 的对照组(n=36)进行比较。测量了海马体、杏仁核、尾状核、壳核、苍白球、丘脑、前扣带回、后扣带回、岛叶皮质和小脑在 T1 加权 MRI 上相对于玻璃体信号强度的信号强度。
与无 GS 的精神分裂症患者和无或有 GS 的对照组相比,GS 伴精神分裂症患者在 T1 加权 MRI 上几乎所有测量区域的信号强度均显著降低。在 T2 加权 MRI 上,与无 GS 的精神分裂症患者和无或有 GS 的对照组相比,GS 伴精神分裂症患者在几乎所有测量区域的信号强度均显著增加。
伴 GS 的精神分裂症患者在 T1 和 T2 加权 MRI 上存在信号强度的特异性变化,提示 GS 所致精神分裂症特别影响额颞皮质、边缘系统和基底节。