{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:12:22Z","timestamp":1788520342810,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Using dynamic contrast-enhanced (DCE) MR perfusion and MR spectroscopy this study aimed to characterize the blood-brain barrier permeability and metabolite changes in patients with cirrhosis and without covert HE.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Covert HE was defined using psychometric HE score (PHES). The participants were stratified into 3 groups: cirrhosis with covert HE (CHE) (PHES&lt;-4); cirrhosis without HE (NHE) (PHES\u2265-4); and healthy controls (HC). Dynamic contrast-enhanced MRI and MRS were performed to assess K<jats:sub>TRANS<\/jats:sub>, a metric derivative of blood-brain barrier disruption, and metabolite parameters. Statistical analysis was performed using IBM SPSS (v25).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 40 participants (mean age 63\u00a0y; male 71%) were recruited as follows: CHE (n=17); NHE (n=13); and HC (n=10). The K<jats:sub>TRANS<\/jats:sub> measurement in the frontoparietal cortex demonstrated increased blood-brain barrier permeability, where K<jats:sub>TRANS<\/jats:sub> was 0.01\u00b10.02 versus 0.005\u00b10.005 versus 0.004\u00b10.002 in CHE, NHE, and HC patients, respectively (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.032 comparing all 3 groups). Relative to HC with a value of 0.28, the parietal glutamine\/creatine (Gln\/Cr) ratio was significantly higher in both CHE 1.12\u00a0mmoL (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); and NHE 0.49 (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.04). Lower PHES scores correlated with higher glutamine\/Cr (Gln\/Cr) (r=-0.6; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) and lower myo-inositol\/Cr (mI\/Cr) (r=0.6; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) and lower choline\/Cr (Cho\/Cr) (r=0.47; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.004).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>The dynamic contrast-enhanced MRI K<jats:sub>TRANS<\/jats:sub> measurement revealed increased blood-brain barrier permeability in the frontoparietal cortex. The MRS identified a specific metabolite signature with increased glutamine, reduced myo-inositol, and choline, which correlated with CHE in this region. The MRS changes were identifiable in the NHE cohort.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hc9.0000000000000079","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T19:01:18Z","timestamp":1679943678000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Novel magnetic resonance KTRANS measurement of blood-brain barrier permeability correlated with covert HE"],"prefix":"10.1097","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4776-5038","authenticated-orcid":false,"given":"Joga","family":"Chaganti","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"School of Clinical Medicine, St Vincent\u2019s Healthcare Campus, Faculty of Medicine, UNSW, Sydney, 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