Evaluation of cingulate gyrus blood flow in patients with liver cirrhosis.
Although neuropsychological tests are commonly applied to detect minimal hepatic encephalopathy (HE) in patients with liver cirrhosis (LC), they provide no information about the cerebral regions involved. Recently, it has been reported that some populations of alcoholic cirrhotics, with mild HE, have reduced cerebral metabolic rate for glucose in bifrontal cortices and in the anterior cingulate gyrus. We evaluated the degree of reduction in blood flow at the anterior cingulate gyrus and the frontal lobes in cirrhotic patients who underwent single photon emission computed tomography (SPECT). Data were obtained from 47 cirrhotic patients and 47 subjects without LC. Three radiologists unaware of the results of laboratory tests visually evaluated the transaxial, coronal, and sagittal views of SPECT. The area and the degree of blood flow reduction in the anterior cingulate gyrus and frontal lobes were scored. Reduced blood flow in the anterior cingulate gyrus was observed in most LC patients. In patients without overt HE, poor performance in neuropsychological tests was correlated with reduced cerebral blood flow in the anterior cingulate gyrus. Blood flow in the anterior cingulate gyrus as measured by SPECT may be a simple and good indicator of cerebral functional changes in patients with LC.
Iwasa
Motoh
M
Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan. motoh@clin.medic.mie-u.ac.jp
Matsumura
Kaname
K
Nakagawa
Yuri
Y
Yamamoto
Mika
M
Tanaka
Hideaki
H
Horiike
Shinichiro
S
Ikoma
Jiro
J
Kaito
Masahiko
M
Takeda
Kan
K
Adachi
Yukihiko
Y
D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006501:Hepatic Encephalopathy / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015899:Tomography, Emission-Computed, Single-Photon