Serum calcium concentration affects signal changes on diffusion-weighted imaging in hypoglycemic encephalopathy

Area of Science:

• Neurology
• Radiology
• Hepatology

Background:

• Abnormal signals on diffusion-weighted imaging (DWI) can be observed in patients with hepatic encephalopathy (HE).
• HE is a complex neuropsychiatric complication of liver dysfunction.

Purpose of the Study:

• To compare clinical and physiological factors in HE patients with and without abnormal DWI signals.
• To investigate the association between DWI findings and clinical status in HE.

Main Methods:

• Retrospective analysis of HE patients undergoing brain DWI (2002-2010).
• HE diagnosis based on low serum glucose (<50 mg/dL) and altered consciousness.
• Comparison of clinical and physiological parameters including consciousness, outcome, temperature, blood pressure, and serum levels of glucose, calcium, sodium, BUN, and creatinine.

Main Results:

• Three out of nine (33%) HE patients exhibited abnormal DWI signals.
• A trend suggested lower serum calcium in patients with normal DWI findings compared to those with abnormal signals (7.6 ± 1.7 vs. 9.4 ± 0.7 mg/dL, P = .07).
• No significant differences were found in glucose levels, hypoglycemia duration, consciousness, or other parameters between groups.

Conclusions:

• Approximately one-third of HE patients show abnormal DWI signals.
• Low serum calcium levels might be associated with a lower likelihood of abnormal DWI findings in HE patients.