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Journal of Neuroradiology Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mercredi 2 novembre 2011
Doi : 10.1016/j.neurad.2011.09.002
Dynamic susceptibility contrast-enhanced first-pass perfusion MR imaging in patients with subclinical hepatic encephalopathy
IRM de perfusion de premier passage après injection de produit de contraste chez des patients avec encéphalopathie hépatique pauci-symptomatique
Tao Li a, b, Xin Li a, Weihua Zhou a, Xiaoming Cui a, Lin Ma b, ⁎
a Department of Radiology, The General Hospital of Chinese People’s Armed Police Forces, No. 69, Yongding Road, 100039 Beijing, China
b Department of Radiology, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China
Background and purpose
Subclinical hepatic encephalopathy (SHE) is frequently reported on single-photon emission computed tomography (SPECT), but is rarely described with magnetic resonance (MR) techniques. This study aimed to investigate hemodynamic changes in brain basal ganglia in patients with SHE using dynamic susceptibility contrast (DSC)-enhanced MR perfusion imaging.
Twelve patients with SHE and ten age- and education-matched volunteers agreed to undergo MR examination. The scanning protocol included conventional anatomical images and DSC-enhanced perfusion MR imaging. Using MGH perfusion software, parameter maps of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were created. The bilateral caudate nucleus head, globus pallidus, putamen and thalamus were selected as regions of interest (ROI), with ipsilateral white matter of the frontal lobe used as reference. Ratios (ROI versus ipsilateral white matter in frontal lobe) for CBF, CBV and MTT in the patient group were compared with those in the control group.
The CBF ratios for every ROI were higher in SHE patients versus the controls. Statistically, significant increases were detected in the left globus pallidus, putamen and thalamus (P <0.05). For MTT, the reduction in values reached statistical significance in the right head of the caudate nucleus and bilateral thalamus (P <0.05). CBV values were not significantly different compared with those of the control group (P >0.05).
Increased CBF and decreased MTT values in the basal ganglia and thalamus were identified in patients with SHE. The CBF increase was compatible with the idea that the CBF is redistributed from cortical areas to the basal ganglia structures.
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