title: Evaluation of cingulate gyrus blood flow in patients with liver cirrhosis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan. motoh@clin.medic.mie-u.ac.jp
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Kaname
authors.initials: K
authors.lastname: Matsumura
authors.forename: Yuri
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Mika
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Horiike
authors.forename: Jiro
authors.initials: J
authors.lastname: Ikoma
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Adachi
mesh_terms: 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