Quantification of cerebral edema on diffusion tensor imaging in acute-on-chronic liver failure.

Abstract:

:Cerebral edema is a major complication of acute liver failure but may also be seen in other forms of liver failure such as acute-on-chronic liver failure (ACLF) and chronic liver failure (CLF). ACLF develops in patients with previously well-compensated chronic liver disease following acute hepatitis A or E superimposed on underlying liver cirrhosis. The aim of this study was to detect the occurrence, and determine the nature, of cerebral edema in patients with the defined subset of ACLF using diffusion tensor imaging (DTI) metrics. Twenty-three patients with ACLF were studied and compared with 15 healthy controls and 15 patients with CLF. DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), linear anisotropy (CL), planar anisotropy (CP), and spherical isotropy (CS) were calculated by selecting regions of interest in the white matter and deep grey matter of the brain. Significantly decreased FA and increased CS were observed in the anterior limb (ALIC) and posterior limb (PLIC) of the internal capsule and frontal white matter (P<0.05) in patients with different grades (1-4) of ACLF when compared with healthy controls. No significant changes in MD and CP were seen in any brain region. However, significantly decreased CL was observed in the PLIC, caudate nuclei and putamen. In patients with CLF, significantly decreased FA with increased CS in the ALIC and PLIC along with significantly increased MD in the ALIC and caudate nuclei were observed. The presence of significantly decreased FA and CL and increased CS along with no significant change in MD and CP suggests the presence of both intracellular and extracellular components of cerebral edema in patients with ACLF.

journal_name

NMR Biomed

journal_title

NMR in biomedicine

authors

Nath K,Saraswat VA,Krishna YR,Thomas MA,Rathore RK,Pandey CM,Gupta RK

doi

10.1002/nbm.1249

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

713-22

issue

7

eissn

0952-3480

issn

1099-1492

journal_volume

21

pub_type

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