Application Of SWI In The Diagnosis Of Minimal Hepatic Encephalopathy

Objective To analyze the deposition of brain iron in patients with minimal hepatic encephalopathy by measuring the corrected phase value of the region of interest on the corrected phase images of SWI,and to explore the application value of SWI in the diagnosis of MHE.Materials and Methods The patients diagnosed as hepatitis B cirrhosis in our hospital were selected as the study subjects and divided into MHE group and simple cirrhosis group by digital connection test-A and digit symbol test,20 healthy volunteers of the same age and sex were enrolled as the healthy control group.All subjects underwent routine MRI and SWI scan.The bilateral frontal white matter and caudate nucleus,putamen,globus pallidus,thalamus,substantia nigra and red nucleus was outlined on corrected phase images,and the corrected phase values of the corresponding regions were obtained.The correlation between the corrected phase value of the normal control group and the reference value of brain iron content in normal adults reported by Hallgren and Sourander were compared.Compare the corrected phase value of the corresponding regions of interest on the left and right sides of the normal control group;compare the CP values between the three groups,and analyze the correlation between corrected phase value of MHE group and neuropsychological tests(NCT-A and DST).Results1.There was a highly negative correlation between the corrected phase value of the regions of interest in the normal control group and the reference values of brain iron content in normal adults reported by Hallgren and Sourander(r=-0.834,P=0.02).2.In the normal control group,The corrected phase value between the left and right frontal white matter was significantly different(P<0.05).There was no significant difference in the remaining brain regions(P>0.05).3.Compared with the simple cirrhosis group,the corrected phase values of the left caudate nucleus,the left putamen and the right thalamus in MHE group were significantly decreased(P<0.05);compared with the healthy control group,the corrected phase values of the white matter and left caudate nucleus were significantly decreased(P<0.05).The corrected phase values of bilateral frontal white matter,bilateral thalamus,left putamen and left red nucleus in patients with cirrhosis were significantly lower than those in healthy controls(P<0.05).There was no significant difference in the corrected phase values of the remaining ROI among the three groups(P>0.05).4.The completion time of NCT-A was negatively correlated with the corrected phase values of bilateral putamen(right,r =-0.571,P=0.026;left,r =-0.614,P=0.015).Meanwhile,the DST score was positively correlated with the corrected phase value of the left putamen(r = 0.559,P = 0.03).Conclusion1.The negative correlation between corrected phase values and brain iron content measured by SWI technique suggests that SWI is a reliable method for indirectly measuring brain iron content.2.In healthy people,the distribution of cerebral iron is biased,and the content of iron in the left brain is often greater than the right.3.There was abnormal brain iron deposition in some brain regions of patients with MHE.The contents of brain iron in the left caudate nucleus,left putamen nucleus and right thalamus were higher in the MHE group than in the simple cirrhosis group;and the white matter of the right frontal lobe in the MHE group was higher than that in the healthy control group.In cirrhosis group,the contents of iron in bilateral frontal white matter,bilateralthalamus,left putamen and left red nucleus were higher than those in healthy controls.4.MHE patients with different degrees of cognitive impairment associated with abnormal brain iron deposition in some brain areas,especially the bilateral putamen.5.SWI can identify patients with MHE from cirrhosis,it is of great significance for the early diagnosis of MHE and may become a new tool for the diagnosis of MHE,providing a new method for the future clinical research on MHE.