• Hua-Jun Chen, Peng-Fei Liu, Qiu-Feng Chen, and Hai-Bin Shi.
• 1 Department of Radiology, Fujian Medical University Union Hospital, 29 Xinquan Rd, Fuzhou 350001, China.
• AJR Am J Roentgenol. 2017 Nov 1; 209 (5): 1128-1135.

ObjectiveThis study aimed to investigate whole-brain microstructural abnormalities and their correlation with cognitive impairment in patients with cirrhosis using diffusion kurtosis imaging (DKI).Subjects And MethodsEighteen patients with cirrhosis and 17 healthy control subjects underwent DKI. Cognition was measured using psychometric hepatic encephalopathy (HE) scores. Whole-brain voxel-based analyses were performed to investigate between-group differences in DKI-derived parameters, including mean kurtosis, axial kurtosis, and radial kurtosis.ResultsCompared with control subjects, the patients with cirrhosis had lower psychometric HE scores, indicating cognitive impairments. The patients with cirrhosis had significantly lower global mean kurtosis, axial kurtosis, and radial kurtosis in gray matter (GM) and white matter (WM). Voxel-based analyses showed that patients with cirrhosis had decreased mean kurtosis, axial kurtosis, and radial kurtosis in diffuse GM regions (particularly in the cingulate cortex, precuneus, insular cortex, frontal areas, basal ganglia, hippocampus and parahippocampal gyrus, supramarginal gyrus and angular gyrus, postcentral and precentral gyrus, and cerebellum) and WM regions (particularly in the corpus callosum, internal capsule, frontal regions, parietal regions, occipital regions, and cerebellum). The DKI metrics were positively correlated with psychometric HE score among patients.ConclusionLower DKI parameters suggest decreased brain microstructural complexity in patients with cirrhosis, which may contribute to the neurobiologic basis of cognitive impairment.

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