BACKGROUND: Brain edema and increased intracranial pressure worsen prognosis in patients with end-stage chronic cirrhosis. OBJECTIVE: To use diffusion-weighted imaging (DWI) to quantify water apparent diffusion coefficient (ADC) in different brain regions of patients with chronic liver failure with or without hepatic encephalopathy. METHODS: The authors studied 14 patients with viral liver cirrhosis and 12 sex- and age-matched healthy volunteers. Seven patients had no clinical evidence of hepatic encephalopathy; six had grade I hepatic encephalopathy; and one had grade II hepatic encephalopathy. Brain DWI was obtained using a single-shot echo-planar imaging sequence, and four gradient strengths (b values = 0, 300, 600, and 900 s/mm(2)) were applied to calculate the average diffusivity maps. RESULTS: Mean ADC values in the brains of patients with cirrhosis were significantly increased in all selected regions of interest (caudate, putamen, and pallidus nuclei; occipital, parietal, and frontal lobe white matter) except in the thalamus. Venous ammonia was linearly related to ADC values in deep gray and white matter regions of interest. CONCLUSIONS: Brain water apparent diffusion coefficient is increased in patients with chronic liver disease and may be useful in monitoring patients with hepatic encephalopathy.
BACKGROUND: Brain edema and increased intracranial pressure worsen prognosis in patients with end-stage chronic cirrhosis. OBJECTIVE: To use diffusion-weighted imaging (DWI) to quantify water apparent diffusion coefficient (ADC) in different brain regions of patients with chronic liver failure with or without hepatic encephalopathy. METHODS: The authors studied 14 patients with viral liver cirrhosis and 12 sex- and age-matched healthy volunteers. Seven patients had no clinical evidence of hepatic encephalopathy; six had grade I hepatic encephalopathy; and one had grade II hepatic encephalopathy. Brain DWI was obtained using a single-shot echo-planar imaging sequence, and four gradient strengths (b values = 0, 300, 600, and 900 s/mm(2)) were applied to calculate the average diffusivity maps. RESULTS: Mean ADC values in the brains of patients with cirrhosis were significantly increased in all selected regions of interest (caudate, putamen, and pallidus nuclei; occipital, parietal, and frontal lobe white matter) except in the thalamus. Venous ammonia was linearly related to ADC values in deep gray and white matter regions of interest. CONCLUSIONS: Brain water apparent diffusion coefficient is increased in patients with chronic liver disease and may be useful in monitoring patients with hepatic encephalopathy.
Authors: Vijay P B Grover; Mary M E Crossey; Julie A Fitzpatrick; Brian K Saxby; Roberta Shaw; Adam D Waldman; Marsha Y Morgan; Simon D Taylor-Robinson Journal: Metab Brain Dis Date: 2015-08-08 Impact factor: 3.584
Authors: L Chavarria; J Alonso; R García-Martínez; F X Aymerich; E Huerga; C Jacas; V Vargas; J Cordoba; A Rovira Journal: AJNR Am J Neuroradiol Date: 2011-06-23 Impact factor: 3.825
Authors: A M McKinney; B D Lohman; B Sarikaya; E Uhlmann; J Spanbauer; T Singewald; J R Brace Journal: AJNR Am J Neuroradiol Date: 2010-05-06 Impact factor: 3.825
Authors: F Miese; G Kircheis; H J Wittsack; F Wenserski; J Hemker; U Mödder; D Häussinger; M Cohnen Journal: AJNR Am J Neuroradiol Date: 2006-05 Impact factor: 3.825