Whole brain atlas-based diffusion kurtosis imaging parameters for evaluation of minimal hepatic encephalopathy

2021 ◽  
pp. 197140092110269
Author(s):  
Prateek Gupta ◽  
Sameer Vyas ◽  
Teddy Salan ◽  
Chirag Jain ◽  
Sunil Taneja ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Imaging Techniques ◽  
Clinical Stage ◽  
Minimal Hepatic Encephalopathy ◽  
Brain Atlas ◽  
Diffusion Kurtosis Imaging ◽  
Whole Brain ◽  
Diffusion Kurtosis

Background and purposes Minimal hepatic encephalopathy (MHE) has no recognizable clinical symptoms, but patients have cognitive and psychomotor deficits. Hyperammonemia along with neuroinflammation lead to microstructural changes in cerebral parenchyma. Changes at conventional imaging are detected usually at the overt clinical stage, but microstructural alterations by advanced magnetic resonance imaging techniques can be detected at an early stage. Materials and methods Whole brain diffusion kurtosis imaging (DKI) data acquired at 3T was analyzed to investigate microstructural parenchymal changes in 15 patients with MHE and compared with 15 age- and sex-matched controls. DKI parametric maps, namely kurtosis fractional anisotropy (kFA), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK), were evaluated at 64 white matter (WM) and gray matter (GM) regions of interest (ROIs) in the whole brain and correlated with the psychometric hepatic encephalopathy score (PHES). Results The MHE group showed a decrease in kFA and AK across the whole brain, whereas MK and RK decreased in WM ROIs but increased in several cortical and deep GM ROIs. These alterations were consistent with brain regions involved in cognitive function. Significant moderate to strong correlations (–0.52 to –0.66; 0.56) between RK, MK and kFA kurtosis metrics and PHES were observed. Conclusion DKI parameters show extensive microstructural brain abnormalities in MHE with minor correlation between the severity of tissue damage and psychometric scores.

scholarly journals Characterization of brain microstructural abnormalities in cirrhotic patients without overt hepatic encephalopathy using diffusion kurtosis imaging

2019 ◽  
Vol 14 (2) ◽  
pp. 627-638
Author(s):  
Qing Sun ◽  
Wenliang Fan ◽  
Yuan Liu ◽  
Yan Zou ◽  
Natalie Wiseman ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Mean Diffusivity ◽  
Minimal Hepatic Encephalopathy ◽  
Health Concern ◽  
Diffusion Kurtosis Imaging ◽  
Neurocognitive Performance ◽  
Microstructural Alterations ◽  
Additional Information ◽  
Cirrhotic Patients ◽  
Diffusion Kurtosis

Abstract Cirrhosis is a major public health concern. However, little is known about the neurobiological mechanisms underlying brain microstructure alterations in cirrhotic patients. The purpose of this prospective study was to investigate brain microstructural alterations in cirrhosis with or without minimal hepatic encephalopathy (MHE) and their relationship with patients’ neurocognitive performance and disease duration using voxel-based analysis of diffusion kurtosis imaging (DKI). DKI data were acquired from 30 cirrhotic patients with MHE, 31 patients without MHE (NMHE) and 59 healthy controls. All DKI-derived parametric maps were compared across the three groups to investigate their group differences. Correlation analyses were further performed to assess relationships between altered imaging parameters and clinical data. Voxel-based analysis of DKI data results showed that MHE/NMHE patients had increased radial diffusivity, axial diffusivity (AD) and mean diffusivity in addition to decreased axial kurtosis (AK) and fractional anisotropy of kurtosis in several regions. Compared to controls, these regions were primarily the cingulum, temporal and frontal cortices. The DKI metrics (i.e., AK and AD) were correlated with clinical variables in the two patient groups. In conclusion, DKI is useful for detecting brain microstructural abnormalities in MHE and NMHE patients. Abnormal DKI parameters suggest alterations in brain microstructural complexity in cirrhotic patients, which may contribute to the neurobiological basis of neurocognitive impairment. These results may provide additional information on the pathophysiology of cirrhosis.

Evaluation of prepulse inhibition and memory impairments at early stage of cirrhosis may be considered as a diagnostic index for minimal hepatic encephalopathy

2017 ◽  
Vol 173 ◽  
pp. 87-94 ◽  
Author(s):  
Iraj Aghaei ◽  
Seyed Soheil Saeedi Saravi ◽  
Samaneh Ghotbi Ravandi ◽  
Masoumeh‎‏‏ Nozari ◽  
Ali Roudbari ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Prepulse Inhibition ◽  
Early Stage ◽  
Minimal Hepatic Encephalopathy ◽  
Memory Impairments ◽  
Inhibition And Memory ◽  
Diagnostic Index

Clinical Stage I Carcinoma of the Uterine Cervix Value of Preoperative Magnetic Resonance Imaging in Assessing Parametrial Invasion

2002 ◽  
Vol 88 (4) ◽  
pp. 291-295 ◽  
Author(s):  
Sandro Sironi ◽  
Massimo Bellomi ◽  
Gaetano Villa ◽  
Silvia Rossi ◽  
Alessandro Del Maschio
Keyword(s):  
Cervical Cancer ◽  
Mr Imaging ◽  
Tumor Invasion ◽  
Early Stage ◽  
Imaging Techniques ◽  
Clinical Stage ◽  
Fast Spin Echo ◽  
Parametrial Invasion ◽  
Early Stage Cervical Cancer ◽  
T2 Weighted Images

Aims and Background The purpose of this prospective study was to assess the efficacy of different MR imaging techniques in the evaluation of parametrial tumor invasion in patients with early stage cervical cancer. Methods A total of 73 consecutive patients, clinically considered to have invasive tumor (<3 cm in diameter) confined to the cervix, underwent MR imaging studies at 1 T, according to the following protocol: fast spin-echo (FSE) T2-weighted, gadolinium-enhanced SE T1-weighted, and fat-suppressed gadolinium-enhanced SE T1-weighted sequences. Images obtained with each sequence were evaluated for parametrial invasion with the use of histopathologic findings as the standard of reference. Results In the assessment of tumor infiltration of the parametrium, with FSE T2-weighted images accuracy was 83%, with SE T1-weighted gadolinium-enhanced images was 65%, and with SE T1-weighted gadolinium-enhanced fat-suppressed images was 72%. The difference between the accuracy rate achieved with FSE T2-weighted images and those obtained with the other two MR sequences was statistically significant (P <0.05). The high negative predictive value (95%) for the exclusion of parametrial tumor invasion was the principal contributor to the staging accuracy obtained with FSE T2-weighted imaging. Conclusions Unenhanced FSE T2-weighted imaging is a reliable method for determining the degree of tumor invasion in patients with early stage cervical cancer. Our data suggest that contrast-enhanced sequences, even with the use of the fat suppression technique, have limited value in assessing tumor extension.

scholarly journals Early Stage Markers of Late Delayed Neurocognitive Decline Using Diffusion Kurtosis Imaging of Temporal Lobe in Nasopharyngeal Carcinoma Patients

2020 ◽  
Vol 11 (20) ◽  
pp. 6168-6177
Author(s):  
Gang Wu ◽  
Shi-shi Luo ◽  
Priya S Balasubramanian ◽  
Gan-mian Dai ◽  
Rui-rui Li ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Temporal Lobe ◽  
Early Stage ◽  
Diffusion Kurtosis Imaging ◽  
Diffusion Kurtosis ◽  
Neurocognitive Decline

scholarly journals CHANGES IN THE MICROSTRUCTURE AND FUNCTION OF BRAIN TISSUE IN PD BY DIFFUSION KURTOSIS IMAGING

2021 ◽  
Author(s):  
LEI WANG ◽  
XIN LIU ◽  
SHUOHUA WU ◽  
FANG CHEN ◽  
YE ZHENG ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Substantia Nigra ◽  
Rating Scale ◽  
Early Stage ◽  
Roc Curves ◽  
Diffusion Kurtosis Imaging ◽  
Diagnostic Efficacy ◽  
Brain Microstructure ◽  
Diffusion Kurtosis

This study proposed to detect changes in brain microstructure in patients with Parkinson’s disease (PD) using diffusion kurtosis imaging (DKI) to quantitatively diagnose early-stage PD. Conventional magnetic resonance imaging and DKI scanning were performed in 24 patients with PD and in 12 age- and sex-matched healthy participants. Hoehn and Yahr (H–Y) stage and Unified Parkinson’s Disease Rating Scale-III (UPDRS-III) scores were obtained from both groups. The mean kurtosis (MK), axial kurtosis, and radial kurtosis of the bilateral substantia nigra on DKI were measured and compared between the two groups. The correlations between MK, H–Y stage, and UPDRS-III scores were determined. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of MK for PD in the substantia nigra. The MK value in the PD group was 0.971. The area under the ROC curve of the substantia nigra was 0.905; the sensitivity and specificity were 0.917 and 0.875, respectively, and the cutoff value was 1.046. The MK of the substantia nigra in the PD group had no significant correlation with the H–Y stages but was negatively correlated with the UPDRS-III scores ([Formula: see text]; [Formula: see text]). Our research identified DKI as a novel tool for the qualitative diagnosis of PD. The optimal MK value for PD diagnosis could be determined with ROC analysis.

The Clinical Relevance of Minimal Hepatic Encephalopathy - A Critical Look

2015 ◽  
Vol 33 (4) ◽  
pp. 555-561 ◽  
Author(s):  
Karin Weissenborn
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Symptoms ◽  
Minimal Hepatic Encephalopathy ◽  
Brain Dysfunction ◽  
Driving Ability ◽  
Blue Collar Workers ◽  
Cerebral Dysfunction ◽  
Increased Risk ◽  
White Collar Workers ◽  
Severe Liver Disease

Minimal hepatic encephalopathy (mHE) is diagnosed in patients with severe liver disease but no clinical symptoms of encephalopathy if either neuropsychological or neurophysiological tests indicate cerebral dysfunction and other possible causes of brain dysfunction have been excluded. mHE is characterized by deficits in attention, visuospatial orientation, visuoconstructive abilities and motor function. Accordingly, mHE can be expected to interfere with a subject's working ability, especially in those occupations that require handiwork, and driving ability. Indeed, about 60% of blue-collar workers with mHE have been shown to be assessed as unfit for work compared to only 20% of white-collar workers, and about 50% of patients with mHE have been judged unfit to drive a car in several studies. mHE interferes with a patient's quality of life and is associated with an increased risk of developing overt HE as well as increased mortality. Whether mHE is of importance for cognitive function after liver transplantation has still to be clarified.

Perfusion SPECT and FDG-PET

2011 ◽  
Vol 23 (S2) ◽  
pp. S25-S31 ◽  
Author(s):  
Karl Herholz
Keyword(s):  
Fdg Pet ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Clinical Stage ◽  
Cortical Atrophy ◽  
Association Cortex ◽  
Amyloid Pet ◽  
Variable Degree ◽  
Multicenter Studies ◽  
Perfusion Spect

ABSTRACTBoth perfusion SPECT and FDG-PET provide images that closely reflect neuronal activity. There is a characteristic regional impairment in Alzheimer's disease (AD) that involves mainly the temporo-parietal association cortices, mesial temporal structures and to a more variable degree also the frontal association cortex. This pattern of functional impairment can provide a biomarker for diagnosis of AD and other neurodegenerative dementias at the clinical stage of mild cognitive impairment, and for monitoring of progression. FDG-PET is quantitatively more accurate and thus better suited to multicenter studies than perfusion SPECT. Regional metabolic and blood flow changes are closely related to clinical symptoms, and most areas involved in these changes will also develop significant cortical atrophy. FDG-PET is complementary to amyloid PET, which targets a molecular marker that does not have a close relation to current symptoms. Current restrictions in the availability and cost of FDG-PET are being reduced, as oncological FDG-PET is being adopted as a standard clinical service in most countries. Limitations in the availability of trained staff should be overcome by training programs set up by professional organizations. Against the background of the development of new criteria for diagnosing AD before the onset of dementia, FDG-PET is expected to play an increasing role in diagnosing patients at an early stage of AD and in clinical trials of drugs aimed at preventing or delaying the onset of dementia.

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