Abhishek Yadav1, Rakesh Kumar Gupta1, Santosh Kumar Yadav1, Vivek Anand Saraswat2, Murali Rangan2, Anshu Srivastava3, Richa Trivedi4, Surendra Kumar Yachha, Ram KS Rathore5
1Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, India; 2Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, Lucknow, Uttar pradesh; 3Paediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, India; 4Nuclear Magnetic Resonance Research Centre, Institute of Nuclear Medicine and Allied Sciences, NEW DELHI, India; 5Mathematics & Statistics, Indian Institute of Technology, Kanpur
Mammillary body (MB) atrophy in alcoholic liver disease usually indicates thiamine deficiency. The purpose of this study was to explore the relationship among blood thiamine, MBs, major fiber bundle FA, and volume changes with DTT in patients with ALF and ACLF of nonalcoholic etiology. In 7 ALF patients, follow-up study was done after clinical recovery at 5 weeks. Blood thiamine, MBs & fornix volume, and fornix fiber bundle FA were significantly decreased as compared to controls. Blood thiamine showed significant positive correlation with MBs volume only. On follow-up study, ALF patients showed significant reversibility only in blood thiamine level and MBs volume. MBs volume changes are primarily a consequence of thiamine deficiency, which may secondarily result in microstructural changes in the fornix. These observable changes are known to be specific and may be reversible with restoration of blood thiamine level. These imaging changes may be used as imaging biomarker of thiamine deficiency in these patients in future.
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