Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
AJNR Am J Neuroradiol. 2012 Feb;33(2):297-300. doi: 10.3174/ajnr.A2766. Epub 2011 Oct 27.
Abnormal signals in brain DWI may appear in patients with HE. The aim of this study was to compare the clinical condition and various physiologic factors between patients with HE with and without abnormal signal intensity changes on DWI.
We retrospectively enrolled patients with HE who underwent brain DWI studies from January 2002 to November 2010. A diagnosis of HE was defined as low serum glucose levels (<50 mg/dL) with alteration of consciousness. Several clinical conditions and physiologic parameters were compared between patients with and without abnormal signals on DWI, including consciousness levels; outcome; body temperature; blood pressure; and serum levels of glucose, calcium, sodium, blood urea nitrogen, and creatinine.
Nine patients with HE were included, and 3 of them (33%) had abnormal signals on brain DWI. There was a trend toward serum calcium concentrations being lower in patients with normal findings on DWI studies compared with patients with abnormal DWI signals (7.6 ± 1.7 versus 9.4 ± 0.7 mg/dL, P = .07). Serum glucose concentration, duration of hypoglycemia, consciousness levels, other physiologic parameters, and clinical outcome did not reveal any differences between the 2 groups.
One-third of patients with HE had abnormal signals on brain DWI, and patients with low serum calcium levels may be less likely to present with abnormal DWI signals.
肝性脑病（HE）患者的脑弥散加权成像（DWI）可能出现异常信号。本研究旨在比较伴有和不伴有 DWI 信号强度异常改变的 HE 患者的临床状况和各种生理因素。
我们回顾性纳入了 2002 年 1 月至 2010 年 11 月间因疑似 HE 行脑 DWI 检查的患者。HE 的诊断标准为低血糖（<50mg/dL）伴意识改变。我们比较了伴有和不伴有 DWI 异常信号的 HE 患者的几种临床状况和生理参数，包括意识水平、预后、体温、血压、血糖、钙、钠、血尿素氮和肌酐的血清水平。
共纳入 9 例 HE 患者，其中 3 例（33%）DWI 检查有异常信号。DWI 检查正常的患者血清钙浓度较 DWI 异常信号患者低，差异有统计学意义（7.6±1.7 与 9.4±0.7mg/dL，P=0.07）。两组患者的血糖浓度、低血糖持续时间、意识水平、其他生理参数和临床预后均无差异。
三分之一的 HE 患者脑 DWI 有异常信号，低钙血症患者出现 DWI 异常信号的可能性较小。
