title: Quantitative measurements of brain iron deposition in cirrhotic patients using susceptibility mapping.
abstract: BACKGROUND
  Susceptibility-weighted imaging (SWI) has been used to detect micro-bleeds and iron deposits in the brain. However, no reports have been published on the application of SWI in studying iron changes in the brain of cirrhotic patients.
  
  
  OBJECTIVE
  To compare the susceptibility of different brain structures in cirrhotic patients with that in healthy controls and to evaluate susceptibility as a potential biomarker and correlate the measured susceptibility and cadaveric brain iron concentration for a variety of brain structures.
  
  
  METHODS
  Forty-three cirrhotic patients (27 men, 16 women; mean age, 50 ± 9 years) and 34 age- and sex-matched healthy controls (22 men, 12 women; mean age, 47 ± 7 years) were included in this retrospective study. Susceptibility was measured in the frontal white matter, basal ganglia, midbrain, and dentate nucleus and compared with results gathered from two postmortem brain studies. Correlation between susceptibility and clinical biomarkers and neuropsychiatric tests scores was calculated.
  
  
  RESULTS
  In cirrhotic patients, the susceptibility of left frontal white matter, bilateral caudate head, and right substantia nigra was higher than that in healthy controls (P < 0.05). There was a positive correlation between susceptibility and iron concentration from one postmortem brain study (r = 0.835, P = 0.01) in eight deep grey matter structures and another in five brain structures (r = 0.900, P = 0.03). The susceptibility of right caudate head (r = 0.402) and left caudate head (r = 0.408) correlated with neuropsychological test scores (both P < 0.05).
  
  
  CONCLUSIONS
  Abnormal iron deposits occur in cirrhotic patients and abnormal susceptibility of some brain regions appears to reflect neurocognitive changes.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China Department of Medical Imaging, Tianjin First Central Hospital, Tianjin, PR China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Xia
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Zheng
authors.affiliation: Department of Medical Imaging, Tianjin First Central Hospital, Tianjin, PR China.
authors.forename: Wen
authors.initials: W
authors.lastname: Shen
authors.affiliation: McMaster University, Hamilton, Ontario, PR China.
authors.forename: Saifeng
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China kevinzhlj@163.com.
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Wayne State University, Detroit, MI, USA.
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China.
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Lu
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000473:pathology*; D001923:Brain Chemistry; D001927:Brain Diseases / Q000209:etiology / Q000473:pathology; D001931:Brain Mapping / Q000379:methods*; D002102:Cadaver; D004198:Disease Susceptibility / Q000097:blood; D005260:Female; D006801:Humans; D007501:Iron / Q000032:analysis*; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D012016:Reference Values; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D007501:Iron
keywords: Cirrhosis; iron deposition; mapping; susceptibility-weighted imaging