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Altered brain iron deposition in patients with minimal hepatic encephalopathy: an MRI quantitative susceptibility
1Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
Aim:
To explore the use of quantitative susceptibility mapping (QSM) in assessing changes in brain iron deposits and their association with cognitive function in patients with minimal hepatic encephalopathy (MHE).
Materials And Methods:
The study cohort comprised 27 cases with hepatitis B-associated cirrhosis with MHE (MHE group), 25 with hepatitis B-associated cirrhosis without MHE (NMHE group), and 25 healthy controls (HC group). Iron deposits in the bilateral frontal white matter, caudate nucleus (CN), putamen, globus pallidus, thalamus, red nucleus, substantia nigra (SN), hippocampus, and dentate nucleus were measured by QSM. The associations between iron deposition with the time taken to complete number connection tests A (NCT-A) and the score on digital-symbol test (DST) were analysed.
Results:
Susceptibility values differed significantly in the bilateral CN, left thalamus, right SN, and left hippocampus in the MHE group compared with the other groups and were positively associated with the times taken to complete the NCT-A in the bilateral CN, left thalamus, and right SN and negatively associated with DST scores in the bilateral CN, left TH, and left HP.
Conclusion:
Reduced cognitive function in MHE patients was significantly associated with abnormally increased iron deposition in certain brain areas. The quantification of brain iron deposition by QSM may thus be an objective and accurate means of evaluating MHE.
Insights
Quantitative susceptibility mapping (QSM) revealed increased brain iron deposits in patients with minimal hepatic encephalopathy (MHE), correlating with cognitive decline. QSM offers an objective method for evaluating MHE.
Area of Science:
- Neuroimaging
- Medical Physics
- Hepatology
Background:
- Minimal hepatic encephalopathy (MHE) is a subtle neurological complication of liver disease.
- Cognitive impairment in MHE is linked to neurochemical alterations, including iron accumulation.
- Accurate assessment of brain iron is crucial for understanding MHE pathophysiology.
Purpose of the Study:
- To investigate the utility of quantitative susceptibility mapping (QSM) for quantifying brain iron deposits in MHE patients.
- To explore the association between QSM-measured iron deposition and cognitive function deficits in MHE.
Main Methods:
- QSM was employed to measure iron deposits in specific brain regions of 27 MHE patients, 25 non-MHE cirrhotic patients, and 25 healthy controls.
- Iron deposition levels were analyzed in areas including the caudate nucleus, thalamus, substantia nigra, and hippocampus.
- Cognitive function was assessed using the Number Connection Test A (NCT-A) and Digital-Symbol Test (DST).
Main Results:
- Significant differences in susceptibility values (indicating iron deposition) were observed in the caudate nucleus, thalamus, substantia nigra, and hippocampus of MHE patients compared to controls.
- Increased iron deposition in these regions positively correlated with longer NCT-A completion times and negatively correlated with DST scores.
Conclusions:
- Abnormally increased brain iron deposition, quantifiable by QSM, is significantly associated with reduced cognitive function in MHE.
- QSM provides an objective and accurate method for evaluating brain iron changes and their impact in MHE.
