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Decrease of regional cerebral blood flow in liver cirrhosis.

M Iwasa1, K Matsumura, M Kaito

  • 1Third Department of Internal Medicine, Mie University, Tsu, Japan. motoh@cln.medic.mie-u.ac.jp

European Journal of Gastroenterology & Hepatology
|September 28, 2000
PubMed
Summary
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Liver cirrhosis patients show reduced regional cerebral blood flow (rCBF), especially in the frontal lobe. Tc-99m ECD SPECT can detect these brain function changes.

Area of Science:

  • Neurology
  • Hepatology
  • Medical Imaging

Background:

  • Liver cirrhosis can affect brain function, but alterations in regional cerebral blood flow (rCBF) are not fully understood.
  • Hepatic encephalopathy is a known complication, but subclinical changes in rCBF require further investigation.

Purpose of the Study:

  • To quantitatively evaluate regional cerebral blood flow (rCBF) changes in liver cirrhosis patients using single photon emission computed tomography (SPECT).
  • To correlate rCBF with disease severity and clinical parameters.

Main Methods:

  • Twenty-eight liver cirrhosis patients (Child-Pugh A, B, C) and 25 healthy controls underwent Tc-99m ethyl cysteinate dimer (ECD) SPECT.
  • Regional cerebral blood flow (rCBF) was calculated using the Patlak graphical method in various brain regions.

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Main Results:

  • Cirrhotic patients exhibited significantly lower rCBF across all measured brain regions compared to controls.
  • rCBF reduction was most pronounced in the frontal lobe (15% decrease) and correlated negatively with liver disease severity (Child-Pugh score).
  • No significant correlation was found between rCBF and age, neuropsychological tests, or most laboratory results.

Conclusions:

  • Liver cirrhosis, even without advanced encephalopathy, is associated with widespread rCBF reduction, particularly in the frontal lobe.
  • Tc-99m ECD SPECT is a valuable tool for assessing cerebral functional alterations in liver cirrhosis patients.