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Keywords:
Oedema, Diagnostic procedure, MR-Functional imaging, Neuroradiology brain
Authors:
G. S. Seifeldein, E. A. Hassan, A. S. E.-D. Abd El-Rehim, G. A. Shehata; Assiut/EG
DOI:
10.1594/ecr2016/C-0864
Results
(A) Characteristics of the study population:
The baseline sociodemographic and biochemical characteristics of the study population were summarized in table 1.
Table I Clinical and laboratory characteristics of the study population
|
Control
(n = 10)
|
CHC
(n = 20)
|
LC
(n = 40)
|
Age (years) mean ± SD
|
52.5 ± 8.6 |
49.7 ± 10.3 |
54.4 ± 8.4 |
Sex (n)
Male
Female
|
5 (50%)
5 (50%)
|
14 (70%)
6 (30%)
|
26 (65%)
14 (35%)
|
Child-Pugh score (mean ± SD)
|
-
|
-
|
12.5 ± 1.4
|
Child-Pugh class (A/B/C) (n)
|
-
|
-
|
(19/24/37)
|
MELD score mean ± SD
|
-
|
-
|
18.7 ± 7.3
|
ALT (IU/L) mean ± SD
|
-
|
45.6 ± 17.7
|
62.5 ± 48.7
|
AST (IU/L) mean ± SD
|
-
|
32.2 ± 11.4
|
86 ± 47.4
|
Serum albumin (g/dl) mean ± SD
|
-
|
4.7 ± 0.3
|
2.3 ± 0.4
|
Serum bilirubin (µmol/l) mean ± SD
|
-
|
10 ± 3.6
|
49.5 ± 29.8
|
Prothrombin time (seconds)
|
-
|
12.2 ± 1.1
|
22.6 ± 4.3
|
(B) Magnetic resonance imaging findings:
On conventional MR imaging,
all study population showed no abnormality e.g.
gross brain edema.
As regarding DWI,
ADC values were similar in corresponding right and left hemispheres in both normal subjects and patients and,
thus,
are reported as mean values (figure 1).
In cirrhotics,
mean ADC values were significantly increased in parietal white matter (WM) and thalamus compared to CHC patients and controls.
The increase in ADC in the pons of cirrhotics did not reach statistical significance (table 2).
In all the examined brain areas,
the ADC increase tended to be higher in relation to the severity of HE and reached statistical significance in the parietal WM (P = 0.03).
There was no significant difference between patients with and without MHE regarding ADC (Figure 2).
In addition,
no statistically significant difference in ADC values between CHC patients with and without neuropsychiatric and cognitive changes (Figure 3).
Table 2 Brain water ADC values in the study groups
|
CHC*
|
LC
|
Controls
|
P
|
Pons
|
0.70 ± 0.01
|
0.75 ± 0.1
|
0.73 ± 0.05
|
0.5
|
Thalamus
|
0.72 ± 0.03
|
0.77 ± 0.05
|
0.71 ± 0.04
|
0.007
|
Parietal WM
|
0.76 ± 0.01
|
0.86 ± 0.08
|
0.77 ± 0.03
|
< 0.001
|
* No significant difference between CHC patients and controls regarding ADC values