Serum proinflammatory cytokines correlate with diffusion tensor imaging derived metrics and 1H-MR spectroscopy in patients with acute liver failure
Serum proinflammatory cytokines correlate with diffusion tensor imaging derived metrics and 1H-MR spectroscopy in patients with acute liver failure
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DOI：
10.1007/s11011-010-9206-x
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Saraswat, Vivek Anand
中科院分区：
文献类型：
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作者：
Gupta, Rakesh Kumar;Yadav, Santosh Kumar;Saraswat, Vivek Anand
高氨血症和炎症是急性肝功能衰竭（ALF）患者发生脑水肿（CE）的主要因素。本研究的目的是寻找促炎细胞因子与扩散张量成像（DTI）衍生的指标和H-1-MR波谱（H-1-MRS）衍生的谷氨酸/谷氨酰胺（Glx）之间的关系。本研究纳入了14例ALF患者和14例年龄/性别匹配的对照。所有受试者均接受了临床、生化、MR成像和H-1-MRS研究。计算血清促炎细胞因子（IL-6和TNF-α）、血氨水平和Glx，进行独立t检验和Pearson相关性。与对照组相比，ALF患者血清促炎细胞因子、血氨水平和脑Glx显着升高。血氨水平和Glx与促炎细胞因子呈显著正相关。光谱体素导出的球形各向异性（CS）与Glx呈正相关，而平均扩散率（MD）呈负相关。在包括光谱体素在内的各个脑区，促炎细胞因子与CS呈正相关，与MD呈负相关。Glx、CS和MD与促炎性细胞因子的显著相关性表明，DTI衍生指标和H-1-MRS均可测量高血氨和促炎性细胞因子的协同作用，并可用作了解ALF中CE发病机制的非侵入性工具。
Hyperammonemia and inflammation are major contributing factors in the development of cerebral edema (CE) in acute liver failure (ALF). Aim of this study was to look for the relationship between proinflammatory cytokines with diffusion tensor imaging (DTI) derived metrics and H-1-MR spectroscopy (H-1-MRS) derived Glutamate/Glutamine (Glx). Fourteen patients with ALF and 14 age/sex matched controls were included in this study. All subjects had undergone clinical, biochemical, MR imaging and H-1-MRS studies. Serum proinflammatory cytokines (IL-6 and TNF-alpha), blood ammonia level and Glx were computed for independent t-test and Pearson correlation. Serum proinflammatory cytokines, blood ammonia level and brain Glx were significantly increased in ALF patients as compared to controls. Blood ammonia level and Glx showed significant positive correlation with proinflammatory cytokines. Spectroscopy voxel derived spherical anisotropy (CS) showed positive correlation with Glx while mean diffusivity (MD) showed negative correlation. Proinflammatory cytokines showed positive correlation with CS and negative correlation with MD in various brain regions including spectroscopy voxel. Significant correlation of Glx, CS and MD with proinflammatory cytokines suggests that both DTI derived metrics and H-1-MRS measure the synergistic effect of hyperammonemia and proinflammatory cytokines and may be used as non-invasive tools for understanding the pathogenesis of CE in ALF.