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Abstract #1082

Diffusion Tensor Imaging Supports the Cytotoxic Origin of Brain Edema in Experimental Hepatic Encephalopathy

Laia Chavarria1, Marc Oria1, Juli Alonso2, Juan Crdoba1, Silvia Lope-Piedrafita3

1Liver Unit, CIBEREHD, Hospital Vall Hebron, Barcelona, Spain; 2Magnetic Resonance Unit, CIBEREHD, Hospital Vall Hebron, Barcelona, Spain; 3Servicio de Resonancia Magntica Nuclear, CIBER-BBN, Universidad Autnoma de Barcelona, Cerdanyola del Valles, Barcelona, Spain

T2 mapping, ADC mapping and localized spectroscopy were performed on a rat model of hepatic encephalopathy aiming to detect brain abnormalities that support the development of brain edema secondary to the metabolism of ammonia to glutamine in astrocytes. An increase in ADC was detected compatible with the development of cytotoxic brain oedema. This abnormality was present at early stages, precedes the development of neurological manifestations and is accompanied by an increase in glutamine due to ammonium accumulation and a decrease in myo-inositol to compensate for it. At coma stage, a significant increase in lactate was observed, sign of anaerobic metabolism activation.