Abstract
Background & Aims: We applied advanced magnetic resonance imaging and Voxed based Morphometry analysis to assess brain tissue density in patients with cirrhosis. Methods: Forty eight patients with cirrhosis without overt hepatic encephalopathy (17 Child A, 13 Child B, and 18 Child C) and 51 healthy subjects were matched for age and sex. Seventeen patients had history of overt hepatic encephalopathy, eight of them had minimal hepatic encephalopathy at inclusion, 10 other patients had minimal hepatic encephalopathy at inclusion but without history of previous overt hepatic encephalopathy, and 21 patients had none of these features. Results: Patients with cirrhosis presented decreased brain density in many areas of the grey and white matter. The extension and size of the affected areas were greater in patients with alcoholic cirrhosis than in those with post-hepatitic cirrhosis and correlated directly with the degree of liver failure and cerebral dysfunction (as estimated by neuropsychological tests and the antecedent of overt hepatic encephalopathy). Twelve additional patients with cirrhosis who underwent liver transplantation were explored after a median time of 11 months (7-50 months) after liver transplant. At the time of liver transplantation, three patients belonged to class A of the Child-Pugh classification, five to class B and four to class C. Compared to healthy subjects, liver transplant patients showed areas of reduced brain density in both grey and white matter. Conclusions: These results indicate that loss of brain tissue density is common in cirrhosis, progresses during the course of the disease, is greater in patients with history of hepatic encephalopathy, and persists after liver transplantation. The significance, physiopathology, and clinical relevance of this abnormality cannot be ascertained from the current study.
| Original language | English |
|---|---|
| Pages (from-to) | 564-573 |
| Number of pages | 10 |
| Journal | Journal of Hepatology |
| Volume | 55 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2011 |
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Keywords
- Cirrhosis
- Hepatic encephalopathy
- Magnetic resonance images
- Voxel-based Morphometry
ASJC Scopus subject areas
- Hepatology
Cite this
Cerebral magnetic resonance imaging reveals marked abnormalities of brain tissue density in patients with cirrhosis without overt hepatic encephalopathy. / Guevara, Mónica; Baccaro, María E.; Gómez-Ansón, Beatriz; Frisoni, Giovanni; Testa, Cristina; Torre, Aldo; Molinuevo, José Luis; Rami, Lorena; Pereira, Gustavo; Sotil, Eva Urtasun; Córdoba, Joan; Arroyo, Vicente; Gins, Pere.
In: Journal of Hepatology, Vol. 55, No. 3, 09.2011, p. 564-573.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Cerebral magnetic resonance imaging reveals marked abnormalities of brain tissue density in patients with cirrhosis without overt hepatic encephalopathy
AU - Guevara, Mónica
AU - Baccaro, María E.
AU - Gómez-Ansón, Beatriz
AU - Frisoni, Giovanni
AU - Testa, Cristina
AU - Torre, Aldo
AU - Molinuevo, José Luis
AU - Rami, Lorena
AU - Pereira, Gustavo
AU - Sotil, Eva Urtasun
AU - Córdoba, Joan
AU - Arroyo, Vicente
AU - Gins, Pere
PY - 2011/9
Y1 - 2011/9
N2 - Background & Aims: We applied advanced magnetic resonance imaging and Voxed based Morphometry analysis to assess brain tissue density in patients with cirrhosis. Methods: Forty eight patients with cirrhosis without overt hepatic encephalopathy (17 Child A, 13 Child B, and 18 Child C) and 51 healthy subjects were matched for age and sex. Seventeen patients had history of overt hepatic encephalopathy, eight of them had minimal hepatic encephalopathy at inclusion, 10 other patients had minimal hepatic encephalopathy at inclusion but without history of previous overt hepatic encephalopathy, and 21 patients had none of these features. Results: Patients with cirrhosis presented decreased brain density in many areas of the grey and white matter. The extension and size of the affected areas were greater in patients with alcoholic cirrhosis than in those with post-hepatitic cirrhosis and correlated directly with the degree of liver failure and cerebral dysfunction (as estimated by neuropsychological tests and the antecedent of overt hepatic encephalopathy). Twelve additional patients with cirrhosis who underwent liver transplantation were explored after a median time of 11 months (7-50 months) after liver transplant. At the time of liver transplantation, three patients belonged to class A of the Child-Pugh classification, five to class B and four to class C. Compared to healthy subjects, liver transplant patients showed areas of reduced brain density in both grey and white matter. Conclusions: These results indicate that loss of brain tissue density is common in cirrhosis, progresses during the course of the disease, is greater in patients with history of hepatic encephalopathy, and persists after liver transplantation. The significance, physiopathology, and clinical relevance of this abnormality cannot be ascertained from the current study.
AB - Background & Aims: We applied advanced magnetic resonance imaging and Voxed based Morphometry analysis to assess brain tissue density in patients with cirrhosis. Methods: Forty eight patients with cirrhosis without overt hepatic encephalopathy (17 Child A, 13 Child B, and 18 Child C) and 51 healthy subjects were matched for age and sex. Seventeen patients had history of overt hepatic encephalopathy, eight of them had minimal hepatic encephalopathy at inclusion, 10 other patients had minimal hepatic encephalopathy at inclusion but without history of previous overt hepatic encephalopathy, and 21 patients had none of these features. Results: Patients with cirrhosis presented decreased brain density in many areas of the grey and white matter. The extension and size of the affected areas were greater in patients with alcoholic cirrhosis than in those with post-hepatitic cirrhosis and correlated directly with the degree of liver failure and cerebral dysfunction (as estimated by neuropsychological tests and the antecedent of overt hepatic encephalopathy). Twelve additional patients with cirrhosis who underwent liver transplantation were explored after a median time of 11 months (7-50 months) after liver transplant. At the time of liver transplantation, three patients belonged to class A of the Child-Pugh classification, five to class B and four to class C. Compared to healthy subjects, liver transplant patients showed areas of reduced brain density in both grey and white matter. Conclusions: These results indicate that loss of brain tissue density is common in cirrhosis, progresses during the course of the disease, is greater in patients with history of hepatic encephalopathy, and persists after liver transplantation. The significance, physiopathology, and clinical relevance of this abnormality cannot be ascertained from the current study.
KW - Cirrhosis
KW - Hepatic encephalopathy
KW - Magnetic resonance images
KW - Voxel-based Morphometry
UR - http://www.scopus.com/inward/record.url?scp=84860389223&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84860389223&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2010.12.008
DO - 10.1016/j.jhep.2010.12.008
M3 - Article
C2 - 21163310
AN - SCOPUS:84860389223
VL - 55
SP - 564
EP - 573
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 3
ER -