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• Clinical Article •
Relationship between focal white matter hyperintensity and minimal hepatic encephalopathy in patients with hepatitis B virus-related cirrhosis
ZHENG Wei  FENG Zhi-chao  ZHU Wen-wei  LI Li-feng  LIAO Yun-jie  LIANG Qi  WANG Wei 

DOI:10.12015/issn.1674-8034.2018.01.005.


[Abstract] Objective: To explore the relationship between focal white matter hyperintensity (WMH) and minimal hepatic encephalopathy (MHE) in patients with hepatitis B virus-related cirrhosis.Materials and Methods: Thirty-eight patients with hepatitis B virus-related cirrhosis, including 20 nHE and 18 MHE, admitted to our institution were included prospectively. All patients underwent neuropsychological tests, blood biochemical determinations and cerebral magnetic resonance imaging. Fluid attenuated inversion recover (FLAIR) images were reviewed for focal WMH by two neuroradiologists, independently. Those with Fazekas scale scores 0-1 were classified as no or mild focal WMH, while those with Fazekas scale scores≥2 were classified as moderate or severe focal WMH. nHE and MHE groups were compared concerning age, gender, duration of cirrhosis, Child-Pugh scale, venous blood ammonia level and the severity of focal WMH. Multivariate logistic regression analysis was performed to evaluate the independent predictor for MHE. The Spearman rank tests were performed to investigate correlation between the severity of focal WMH and cognitive function.Results: Cpmpared with the age and gender-matched nHE group, there were significantly more patients with moderate or severe focal WMH in MHE group (P<0.01). However, duration of cirrhosis, Child-Pugh scale and venous blood ammonia level did not differ significantly between the two groups (all P>0.05). Multivariate logistic regression analysis showed that moderate or severe focal WMH was the independent predictor for MHE(OR=18.62, 95% CI: 2.43—142.86, P<0.05). Correlation analyses showed significant positive correlation between the severity of focal WMH and completion time of NCT-A (r=0.617, P<0.01), significant negative correlations between the severity of focal WMH and scores of DST and digital span test (r=-0.695, P<0.01, r=-0.558, P<0.01).Conclusions: Moderate or severe focal WMH in cirrhotic patients is the independent predictor for MHE, which indicates the possibility of MHE.
[Keywords] Hepatic encephalopathy；Magnetic resonance imaging

ZHENG Wei Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

FENG Zhi-chao Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

ZHU Wen-wei Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

LI Li-feng Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

LIAO Yun-jie Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

LIANG Qi Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

WANG Wei* Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China

*Correspondence to: Wang W, E-mail: cjr.wangwei@vip.163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of project of Natural Science Foundation of Hunan Province No. 2016JJ6149
Received  2017-09-07
Accepted  2017-11-18
DOI: 10.12015/issn.1674-8034.2018.01.005
DOI:10.12015/issn.1674-8034.2018.01.005.

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