Wang Liu-Xian, Guo Li, Guo Fan, Ren Shu-Yao, Fei Ning-Bo, Liu Kang, Liu Lin, Yu Tian-Lei, He Chuang-Ye, Xi Yi-Bin, Tian Ping, Cui Long-Biao, Yin Zhan-Xin, Wang Zheng-Yu, Qin Wei, Han Guo-Hong, Yin Hong
Departments of aRadiology bPsychiatry cDigestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University dSchool of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China.
Neuroreport. 2017 Dec 6;28(17):1164-1169. doi: 10.1097/WNR.0000000000000898.
We aimed to detect alterations in diffusion characteristics of brain white matter in hepatic myelopathy (HM) patients. Liver cirrhosis patients with (n=25) and without (n=18) HM after transjugular intrahepatic portosystemic shunt and 26 healthy controls were enrolled in this study. All participants were scanned with diffusion tensor imaging on a 3T Siemens scanner. Tract-based spatial statistics analysis was used to detect abnormalities of intracranial white matter tracts. Correlations between clinical characteristics and diffusion metrics were also calculated. HM patients showed widespread decreased fractional anisotropy values in association fibers, callosal fibers, thalamic fibers, and limbic system fibers (P<0.01, family-wise error-corrected) compared with healthy controls. In addition, HM patients showed lower fractional anisotropy values in the corpus callosum, corona radiata, external capsule, and superior longitudinal fasciculus compared with cirrhosis patients without myelopathy (P<0.01, family-wise error-corrected). Furthermore, limb muscle strength grading was correlated with the diffusion characteristics of the corpus callosum and superior longitudinal fasciculus in HM patients (P<0.05). HM patients suffer from more distinct changes of white matter fiber tracts than cirrhosis patients without myelopathy. In addition, alterations of the corpus callosum and superior longitudinal fasciculus may be associated with the major motor disturbance in HM. Our finding may shed light on the underlying neuropathological mechanism of HM.
我们旨在检测肝性脊髓病（HM）患者脑白质扩散特性的改变。本研究纳入了经颈静脉肝内门体分流术后发生（n = 25）和未发生（n = 18）HM的肝硬化患者以及26名健康对照者。所有参与者均在一台3T西门子扫描仪上进行扩散张量成像扫描。采用基于纤维束的空间统计学分析来检测颅内白质纤维束的异常情况。还计算了临床特征与扩散指标之间的相关性。与健康对照者相比，HM患者在联合纤维、胼胝体纤维、丘脑纤维和边缘系统纤维中呈现广泛的各向异性分数值降低（P<0.01，经家族性错误校正）。此外，与未发生脊髓病的肝硬化患者相比，HM患者在胼胝体、放射冠、外囊和上纵束中的各向异性分数值更低（P<0.01，经家族性错误校正）。此外，HM患者的肢体肌肉力量分级与胼胝体和上纵束的扩散特性相关（P<0.05）。与未发生脊髓病的肝硬化患者相比，HM患者的白质纤维束变化更为明显。此外，胼胝体和上纵束的改变可能与HM患者的主要运动障碍有关。我们的发现可能有助于揭示HM潜在的神经病理机制。
