Morphometric brain alterations in the liver cirrhosis

Portosystemic encephalopathy (PSE) is a common complication of cirrhosis and presents clinical findings linked to hepatic malfunction and electroencephalographic (EEG) tracing alterations (triphasic waves). Morphoanatomic changes in the brain are measurable by imaging techniques. We used CT scan to measure the bifrontal diameter (BFD%) and the bicaudate diameter (BCD%) in a group of 30 cirrhotics and a group of 10 healthy controls. The grade of portosystemic encephalopathy, the etiology and duration of cirrhosis was assessed. There was a statistically significant difference between mean BFD% in the two groups (p < 0.007). Furthermore, there was an increase of BFD% and BCD% proportional to the duration of the liver disease, the grade of PSE and HCV-related cirrhosis. Our study revealed that CT scanning of the head represents a useful diagnostic tool in severe PSE.