静息态功能磁共振成像评估轻微型肝性脑病患者区域神经活动的动态变化及与临床行为的关系

肝脏 ›› 2025, Vol. 30 ›› Issue (3): 326-329.

静息态功能磁共振成像评估轻微型肝性脑病患者区域神经活动的动态变化及与临床行为的关系

谢晓珍, 杨晓亮, 刘文凤

214000 江苏联勤保障部队904医院医学影像科(谢晓珍,杨晓亮);310000 浙江杭州迪安健检医疗门诊部有限公司医学影像科(刘文凤)

收稿日期:2024-10-18 出版日期:2025-03-31 发布日期:2025-06-16
通讯作者: 刘文凤
基金资助:
无锡市卫生健康委基金(M202208)

Dynamic changes in regional neural activity and its relationship with clinical behavior of patients with mild hepatic encephalopathy using resting state functional magnetic resonance imaging

XIE Xiao-zhen¹, YANG Xiao-liang¹, LIU Wen-feng²

1. Department of Medical Imaging,Joint Logistics Support Force 904 Hospital,Wuxi 214000, China;
2. Department of Medical Imaging, Hangzhou Dian Health Examination Medical Outpatient Department Co., Ltd., Zhejian 310000, China

Received:2024-10-18 Online:2025-03-31 Published:2025-06-16
Contact: LIU Wen-feng

摘要/Abstract

摘要： 目的通过静息态功能磁共振成像分析轻微型肝性脑病(MHE)患者区域神经活动的动态变化及与临床行为的关系。方法选取2020年3月—2022年3月联勤保障部队904医院30例MHE患者作为疾病组,再选取同期30例健康志愿者作为对照组。两组均进行静息态功能磁共振成像、数字连接试验A(NCT-A)、数字符号试验(DST)及蒙特利尔认知评估量表(MoCA)评估,利用滑动时间窗计算动态局部一致性(dReHo)的时间变异性,评估MHE患者脑区局部一致性(ReHo)的时间动态特性,采用Pearson相关性检验分析dReHo变异性和NCT-A、DST及MoCA评分之间的相关性。结果疾病组NCT-A所需时间为(72.5±7.6)s,长于对照组(35.9±5.4)s,DST、MoCA评分为(25.2±3.6)分、(21.0±2.2)分,低于对照组[(48.6±6.5)分、(26.1±3.8)分,P<0.05]。经单因素方差分析,得出疾病组与对照组在左侧额中回、额下回、苍白球、海马、右侧额中回以及颞下回脑区等区域中的dReHo存在显著性差异(P<0.05)。MoCA评分与右侧额中回、颞下回dReHo值呈负相关、正相关(r=-0.5、0.7,P<0.05)。结论 MHE患者大脑活动的协调一致性出现异常,静息态功能磁共振成像dReHo分析在MHE的病情监测方面具有潜在价值,为阐明MHE患者的潜在神经病理机制提供了神经影像学证据。

关键词: 轻微型肝性脑病, 静息态功能磁共振成像, 区域神经活动, 临床行为

Abstract: Objective To analyze the dynamic changes of regional neural activity in patients with mild hepatic encephalopathy (MHE) using resting state functional magnetic resonance imaging and its relationship with clinical behavior.Methods Thirty MHE patients who were diagnosed and treated in Joint Logistics Support Force 904 Hospital between March 2020 and March 2022 were selected as the disease group, 30 healthy volunteers who underwent physical examinations in 904 hospital in Wuxi during the same period of time were selected as the control group. Both groups underwent resting state functional magnetic resonance imaging, digital connectivity test A (NCT-A), digital sign test (DST), and Montreal Cognitive Assessment Scale (MoCA) evaluations. The time variability of dynamic local consistency (dReHo) was calculated using a sliding time window, and the temporal dynamic characteristics of local consistency (ReHo) in the brain region of MHE patients were evaluated. Pearson correlation test was used to analyze the variability of dReHo and NCT-A The correlation between DST and MoCA scores.Results The time required for NCT-A in the disease group was (72.5±7.6) seconds, which was longer than that in the control group (35.9±5.4) seconds. The DST and MoCA scores were (25.2±3.6) points and (21.0±2.2) points, respectively, which were lower than those of (48.6±6.5) points and (26.1±3.8) points in the control group (all P<0.05). Through one-way ANOVA, it was found that there were significant differences in dReHo between the disease group and the control group in the left middle frontal gyrus, inferior frontal gyrus, globus pallidus, hippocampus, right middle frontal gyrus and inferior temporal gyrus (P<0.05). In order to further explore the correlation between dReHo and MoCA score, correlation analysis showed that MoCA score was negatively correlated with the dReHo value of the right middle frontal gyrus and infratemporal gyrus, respectively (r=-0.5, 0.7, P<0.05).Conclusion The coordination and consistency of brain activity in MHE patients are abnormal, and resting state functional magnetic resonance imaging (dReHo) analysis has potential value in monitoring the condition of MHE, providing neuroimaging evidence for elucidating the underlying neuropathological mechanisms of MHE patients.

Key words: Mild hepatic encephalopathy, Resting state functional magnetic resonance imaging, Regional neural activity, Clinical behavior

谢晓珍, 杨晓亮, 刘文凤. 静息态功能磁共振成像评估轻微型肝性脑病患者区域神经活动的动态变化及与临床行为的关系[J]. 肝脏, 2025, 30(3): 326-329.

XIE Xiao-zhen, YANG Xiao-liang, LIU Wen-feng. Dynamic changes in regional neural activity and its relationship with clinical behavior of patients with mild hepatic encephalopathy using resting state functional magnetic resonance imaging[J]. Chinese Hepatolgy, 2025, 30(3): 326-329.

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