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Abstract：
UNASSIGNED: Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality. There is a paucity of data about the spectrum of neuroimaging abnormalities in the brain in ACLF patients. The present study was aimed to study the prevalence of cerebral edema and other parenchymal changes in MR imaging of the brain in patients with ACLF.
UNASSIGNED: In this prospective observational study, MR imaging was done in patients with ACLF (n = 41), and findings were compared with age and sex-matched patients with acute decompensation (AD) (n = 13) and those with cirrhosis but without any decompensation at recruitment (n = 21).
UNASSIGNED: Forty-one patients with ACLF (24.4% Grade 1 and Grade 2, 51.2% Grade 3) with 14 (34.1%) having cerebral failure were included in the study. T2-weighted (T2W) diffuse white matter hyperintensities (WMHs) and focal WMHs were seen in 17 (41.4%) and 7 (17%) patients, respectively. T1W basal ganglia hyperintensities in 20 (48.7%), cerebral microbleeds (CMBs) in 6 (14.6%), and 2 (4.8%) patients had cerebral edema. In patients with AD, T2W diffuse WMHs were seen in 3 (23%), T2W focal WMHs in 3 (23%) patients. None of the patients with AD had cerebral edema or CMBs. In compensated cirrhosis patients, T2W diffuse WMHs were present in 7 (33.3%), T2W focal WMHs in 5 (23.8%), while 3 (14.2%) patients had CMBs. T1 weighted hyperintensities in basal ganglia were more common in AD [9 (69.2%)] and compensated cirrhosis [15 (71.4%)] as compared to ACLF patients [20 (48.7%)], P = 0.174. The survival time of 30 and 90 days for patients with diffuse T2W WMHs was significantly lesser than patients without T2W WMHs (P = 0.007).
UNASSIGNED: Cerebral edema is uncommon in ACLF patients, and T2-weighted diffuse white matter hyperintensities may be associated with worse outcomes. However, due to the limited scope of the present study, the same needs to be explored further in larger cohorts.
UNASSIGNED: In this prospective observational study, MR imaging was done in patients with ACLF (n = 41), and findings were compared with age and sex-matched patients with acute decompensation (AD) (n = 13) and those with cirrhosis but without any decompensation at recruitment (n = 21).
UNASSIGNED: Forty-one patients with ACLF (24.4% Grade 1 and Grade 2, 51.2% Grade 3) with 14 (34.1%) having cerebral failure were included in the study. T2-weighted (T2W) diffuse white matter hyperintensities (WMHs) and focal WMHs were seen in 17 (41.4%) and 7 (17%) patients, respectively. T1W basal ganglia hyperintensities in 20 (48.7%), cerebral microbleeds (CMBs) in 6 (14.6%), and 2 (4.8%) patients had cerebral edema. In patients with AD, T2W diffuse WMHs were seen in 3 (23%), T2W focal WMHs in 3 (23%) patients. None of the patients with AD had cerebral edema or CMBs. In compensated cirrhosis patients, T2W diffuse WMHs were present in 7 (33.3%), T2W focal WMHs in 5 (23.8%), while 3 (14.2%) patients had CMBs. T1 weighted hyperintensities in basal ganglia were more common in AD [9 (69.2%)] and compensated cirrhosis [15 (71.4%)] as compared to ACLF patients [20 (48.7%)], P = 0.174. The survival time of 30 and 90 days for patients with diffuse T2W WMHs was significantly lesser than patients without T2W WMHs (P = 0.007).
UNASSIGNED: Cerebral edema is uncommon in ACLF patients, and T2-weighted diffuse white matter hyperintensities may be associated with worse outcomes. However, due to the limited scope of the present study, the same needs to be explored further in larger cohorts.
摘要：
未经证实：慢性急性肝衰竭(ACLF)与高短期死亡率相关。关于ACLF患者大脑中神经影像学异常的频谱的数据很少。本研究旨在研究ACLF患者脑MR成像中脑水肿和其他实质改变的患病率。
未经评估：在这项前瞻性观察研究中，在患有ACLF的患者中进行了MR成像（n=41），并将结果与年龄和性别匹配的急性代偿失调（AD）患者（n=13）和肝硬化患者（n=21）进行比较。
UNASSIGNED：研究中纳入了41例ACLF患者（24.4％的1级和2级，51.2％的3级），14例（34.1％）患有脑衰竭。在17例（41.4％）和7例（17％）患者中观察到T2加权（T2W）弥漫性白质高强度（WMHs）和局灶性WMHs，分别。T1W基底节高信号20例（48.7%），脑微出血（CMBs）6例（14.6%），2例(4.8%)患者出现脑水肿。在AD患者中，T2W弥漫性WMHs见于3例(23%)，T2W局灶性WMHs患者3例(23%)。AD患者均无脑水肿或CMBs。在代偿性肝硬化患者中，7例(33.3%)存在T2W弥漫性WMHs，T2W局灶性WMHs为5（23.8%），3例（14.2%）患者有CMBs。与ACLF患者[20（48.7％）]相比，基底神经节的T1加权高信号在AD[9（69.2％）]和代偿性肝硬化[15（71.4％）]中更常见，P=0.174。弥漫性T2WWMHs患者30天和90天的生存时间明显少于无T2WWMHs患者（P=0.007）。
未经证实：脑水肿在ACLF患者中并不常见，和T2加权弥漫性白质高强度可能与较差的结果相关。然而,由于本研究范围有限，同样需要在更大的队列中进一步探索。
未经评估：在这项前瞻性观察研究中，
UNASSIGNED：研究中纳入了41例ACLF患者（24.4％的1级和2级，51.2％的3级），14例（34.1％）患有脑衰竭。
未经证实：脑水肿在ACLF患者中并不常见，
