Diffusion Tensor and Magnetization Transfer Imaging of the Brain at 3T in Patients with Cirrhosis.
Hajnal J, Saxby B, Allsop J, Patel N, Bradford E, Taylor-Robinson S, Grover V, Counsell S
Hammersmith Hospital, Imperial College London
Controversy remains regarding the pathogenesis, diagnosis, treatment and monitoring of hepatic encephalopathy; a common complication of cirrhosis. We investigated the cerebral microstructure with diffusion tensor imaging and magnetization transfer imaging of a cohort of patients with cirrhosis. All female patients had minimal hepatic encephalopathy. The magnetization transfer ratio was significantly lower in the frontal white matter. Apparent diffusion coefficients were significantly higher in the anterior corona radiata and genu, body and splenium of the corpus callosum of these female patients. These findings may be compatible with either an increase in brain water or microstructural damage to the white matter tracts.