The Application Value Of Vbm And Sbm Technology In Liver Cirrhosis Mild Hepatic Encephalopathy

Objective:Minimal hepatic encephalopathy is an early stage of hepatic encephalopathy.Patients often have mild neurocognitive dysfunction,but due to mild symptoms and difficult clinical findings,they can only be judged by neuropsychological and physiological tests.However,because neuropsychological tests are susceptible to interference by other factors,it is difficult to popularize the clinic.In recent years,researchers have discovered many changes in the microscopic morphology of the brains of patients with central nervous system diseases because morphological measurement and analysis techniques based on voxel and cortical thickness have been widely applied and researched,thus various types of diseases can be understood better.The main purpose of this study is to use VBM and SBM morphological measurement and analysis technology to explore the changes in the brain microstructure of MHE patients in the context of liver cirrhosis,and hope to help early diagnosis of MHE through relevant evidence of brain morphology.Methods:20 MHE patients in the context of liver cirrhosis in the experimental group and 20 healthy controls were collected.The SPSS 19.0 software was used to statistically analyze the age,sex,education level(years),digital symbol test(DST),and number connection test-A(NCT-A)of the experimental group and the control group.GE 3.0T magnetic resonance scanner was used to perform whole brain 3D high-resolution Tl weighted image f MRI scan.SPM8 and SPM12 software based on Matlab environment were used to post-process the scanned images.Two-sample t test was used to statistically analyze the differences between the two groups in gray matter volume and cortical thickness.Then,the multiple regression statistical model under SPM was used to perform multiple regression analysis on the brain maps and neuropsychological scores of the MHE group and the control group,and statistically significant brain regions were obtained after FDR correction.Results:The results of NCT-A(T=7.984,P<0.001)and DST(Z=3.926,P<0.001)of MHE group and healthy group had statistical differences.There was no significant statistical difference between the MHE group and the healthy group in gender factor(?~2=0.533,P=0.464),and there were no significant differences in factors such as years of education(Z=1.187,P=0.235)and age(T=0.734,P=0.467).VBM technology magnetic resonance imaging studies showed that the gray matter volume of bilateral putamen,amygdala,hippocampus and parahippocampal gyrus and other brain areas in the MHE group was significantly reduced;the gray matter volume of bilateral thalamus was significantly increased(FDR corrected,P<0.05).CAT magnetic resonance imaging studies showed that,compared with the control group,the thickness of bilateral superior frontal gyrus,bilateral middle frontal gyrus,left inferior frontal gyrus,bilateral anterior central gyrus,upper part of bilateral anterior cingulate gyrus,right posterior cingulate gyrus,right inferior temporal gyrus and temporal pole,right insula and other cortexes in the MHE group decreased,while the thickness of the bilateral medial orbitofrontal cortex increased(TFCE corrected,P<0.05).There was no significant correlation(FDR corrected,P<0.05)between the gray matter volume and cortical thickness changes in the control group and the MHE group and the NCT-A time,DST score.Conclusions:This experiment uses NCT-A and DST PHES score scales to test the subjects of MHE group and the healthy group.The results obtained are statistically different,which indicates that the cognitive-related functions of MHE patients do have changed.In addition,in this paper,VBM and CAT magnetic resonance imaging techniques are used to find abnormal changes in the gray matter structure of MHE patients that cannot be found with conventional MRI sequences.The changes in the gray matter structure in these areas are likely to be the neurophysiological basis for the corresponding clinical manifestations of MHE patients(pay attention to impaired performance such as cognition,visual space,motor ability and memory function).