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一个肝脏脑病例与扩散脑干信号变化在磁共振成像上

Hiromu Yurimoto¹, Taiki Matsubayashi¹, Isamu Shibata²

¹Neurology, National Hospital Organization Disaster Medical Center, Tokyo, JPN.

|April 28, 2025

概括

肝脑病可以导致罕见的脑干MRI信号变化. 这些变化,特别是在大脑干中,可能表明代谢性脑病变,并且可以通过治疗解决,这表明预后有利.

科学领域:

神经学神经学
放射学放射学是一门学科.
肝病学肝病学是一种肝病学.

背景情况:

肝发性脑病 (HE) 是肝功能障碍的一个复杂的神经精神疾病并发症.
在HE中大脑MRI发现是可变的,没有病理学征兆.
在HE中,仅限于大脑干的MRI信号变化很少被报告.

研究的目的:

报告一种罕见的肝脏脑病变病例,呈现出单独的脑干MRI信号异常.
为了将成像发现与临床表现和治疗反应相关联.
讨论大脑干局限性MRI改变在HE的诊断和预后影响.

主要方法:

一个75岁妇女的病例介绍,她的意识受损.
实验室测试包括氨和肝功能测试.
大脑MRI包括FLAIR,DWI和ADC映射.
全身CT用于肝脏评估.
临床随访和对治疗的反应.

主要成果:

核磁共振扫描显示了中脑的扩散,对称的超强度,并对FLAIR,DWI和低ADC值进行了测试.
在白球体 (globus pallidus) 中没有发现信号异常.
诊断为肝硬化和初级胆道胆管炎的患者.
用分支链氨基酸治疗4天内意识的临床改善.
脑干MRI异常在第10天之前得到解决.

结论:

在MRI上扩散脑干信号变化的差异诊断中应考虑肝脑病变.
可逆,对称的大脑干MRI发现,特别是DWI/ADC变化,支持代谢性脑病变.
在HE中,大脑干局限的信号变化可能与良好的预后有关.

关键词:

看似的扩散系数.大脑干的大脑干扩散加权成像是一种扩散加权成像.肝脏脑病变 - 肝脏脑病变 - 肝脏脑病变磁共振成像技术的使用

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