Longitudinal Evolution of the Brain Microstructure in Cirrhotic Patients on Diffusion Kurtosis Imaging.

IF 3.3 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Yuan-Yuan Chen, Zi-Ning Lu, Qi Zhang, Yi-Ning Zhang, Wen-Ting Ma, XiaoDi Zhang, Xiao-Dong Zhang, Hong-Yan Ni, Yue Cheng
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引用次数: 0

Abstract

Background: Although improvement of cognitive function after liver transplantation has been demonstrated in several neuropsychological studies, there is limited research on longitudinal changes in the cirrhotic patients' brain structure before and after transplantation.

Purpose: To investigate longitudinal changes of brain microstructure in cirrhotic patients using diffusion kurtosis imaging (DKI).

Study type: Prospective.

Subjects: A total of 153 cirrhosis patients, comprising 60 hepatic encephalopathy (HE) patients (16 females/44 males) and 93 no-HE patients (35 females/58 males), along with 93 healthy controls (HCs) (53 females/40 males) were enrolled. Subsequently, 58 recipients completed 1-month postoperative follow-up, 29 patients completed 1-, 3-months, and 17 patients completed 1-, 3-, 6-month follow-up.

Sequence: Spin-echo single-shot echo-planar sequence using a 3.0 T scanner.

Assessment: Diffusion kurtosis estimator software was used to estimate the DKI parameter maps by a MR imaging physicist (Y.-Y.C. with 12 years of experience).

Statistical tests: The diffusion metrics (eg, radial kurtosis [RK], mean kurtosis, fractional anisotropy, mean diffusivity) of the patients before transplantation were compared with those of the HCs using voxel-wise analysis of variance (ANOVA), along with t tests for post hoc analysis. Linear mixed-effects models were applied to the longitudinal data. We imposed a cluster level Family Wise Error (FWE) correction rate of PFWE = 0.05 with voxel-wise cutoff of P = 0.001 together with a cluster-size cutoff of N ≥ 56, and generated smoothness estimates from the preprocessed data using the mixed-model autocorrelation function.

Results: The RK metrics of the patients decreased significantly in the anterior cingulate cortex (HE/no-HE < HC, ANOVA-F = 21.91). After transplantation, the RK of the pallidum showed a continuous upward trend (time effect T = 11.26); whereas the RK of the right postcentral gyrus showed a continuous downward trend (time effect T = -9.56). In addition, the RK in superior longitudinal fasciculus showed new-onset decrease after transplantation.

Data conclusion: Longitudinal changes in DKI metrics reveal the course of brain microstructural changes before and after transplantation in cirrhotic patients, potentially associated with cognitive alterations after surgery.

Level of evidence: 1 TECHNICAL EFFICACY: Stage 4.

弥散峰度成像显示肝硬化患者大脑微观结构的纵向演变
背景:目的:使用弥散峰度成像(DKI)研究肝硬化患者大脑微观结构的纵向变化:研究类型:前瞻性:共纳入 153 名肝硬化患者,包括 60 名肝性脑病(HE)患者(16 名女性/44 名男性)和 93 名非 HE 患者(35 名女性/58 名男性),以及 93 名健康对照组(HCs)(53 名女性/40 名男性)。随后,58 名受试者完成了术后 1 个月的随访,29 名患者完成了 1、3 个月的随访,17 名患者完成了 1、3、6 个月的随访:自旋回波单发回波平面序列,使用 3.0 T 扫描仪:由一名核磁共振成像物理学家(Y.-Y.C.,有 12 年经验)使用扩散峰度估计软件估计 DKI 参数图:移植前患者的弥散指标(如径向峰度[RK]、平均峰度、分数各向异性、平均弥散度)与 HCs 的弥散指标进行比较,采用方差分析(ANOVA)和 t 检验进行事后分析。线性混合效应模型适用于纵向数据。我们采用了 PFWE = 0.05 的集群水平家族智误(FWE)校正率,以 P = 0.001 作为体素截断点,集群大小截断点为 N ≥ 56,并使用混合模型自相关函数从预处理数据中生成平滑度估计值:结果:在前扣带回皮层,患者的 RK 指标显著下降(HE/no-HE 数据结论:DKI 指标的纵向变化表明,患者的前扣带回皮层的 RK 指标显著下降(HE/no-HE 数据结论):DKI指标的纵向变化揭示了肝硬化患者移植前后大脑微结构变化的过程,可能与术后认知改变有关:1 技术效率:第 4 阶段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.70
自引率
6.80%
发文量
494
审稿时长
2 months
期刊介绍: The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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