Related Experiment Video
Updated: Jul 5, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Quantitative cerebral water content mapping in hepatic encephalopathy
1Institute of Neuroscience and Biophysics 3 - Medicine, Research Centre Jülich GmbH, 52425 Jülich, Germany. n.j.shah@fz-juelich.de
Abstract:
There is increasing evidence that the pathophysiology of hepatic encephalopathy is tightly associated with low-grade cerebral oedema; however, no method has yet specifically and unambiguously confirmed this hypothesis in vivo. The current study describes the quantitative measurement of localised water content using MRI in a cohort of 38 patients suffering from hepatic encephalopathy. A significant global increase in cerebral water content was observed in white matter whereas water content in grey matter was globally unaffected. However, significant spatial variations in the water content distribution, especially in grey matter, were observed and were correlated with disease grade and critical flicker frequency. In addition, regions-of-interest were defined and a significant change in water content with disease grade was found in the frontal and occipital white matter, the globus pallidus, the anterior limb of the internal capsule and the putamen. No association of water content and HE grade was established for the occipital visual and frontal cortices, the thalamus, the posterior limb of the internal capsule, the caudate nucleus and the coronal white matter. In conclusion, the measurements presented here are the first direct and quantitative demonstration of the presence of low-grade cerebral oedema in patients with hepatic encephalopathy. Further, absolute changes in tissue water content were quantified for various brain regions.
Insights
This study quantitatively measured brain water content in hepatic encephalopathy (HE) patients using MRI. Results show low-grade cerebral edema, particularly in white matter, correlating with HE severity.
Area of Science:
- Neurology
- Radiology
- Biochemistry
Background:
- Hepatic encephalopathy (HE) pathophysiology is linked to cerebral edema.
- Previous methods lacked in vivo confirmation of this hypothesis.
- Quantitative MRI offers a novel approach to assess brain water content in HE.
Purpose of the Study:
- To quantitatively measure localized water content in the brains of HE patients using MRI.
- To investigate the relationship between brain water content, HE grade, and cognitive function (critical flicker frequency).
- To provide direct in vivo evidence for low-grade cerebral edema in HE.
Main Methods:
- Magnetic Resonance Imaging (MRI) was used for quantitative measurement of localized water content.
- 38 patients with hepatic encephalopathy were included in the study.
- Regions of interest (ROIs) were defined in grey and white matter for detailed analysis.
Main Results:
- A significant global increase in white matter water content was observed.
- Grey matter water content was globally unaffected but showed significant spatial variations correlated with HE grade.
- Specific ROIs, including frontal/occipital white matter and basal ganglia, showed significant water content changes with HE grade.
Conclusions:
- This study provides the first direct, quantitative in vivo demonstration of low-grade cerebral edema in hepatic encephalopathy patients.
- Tissue water content changes were quantified across various brain regions, offering insights into HE pathophysiology.
- Findings highlight the utility of quantitative MRI in assessing brain edema in neurological conditions.
