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Normalization of T2 signal abnormalities in hemispheric white matter with liver transplant

From the Magnetic Resonance Unit (IDI) (Department of Radiology) (Drs. Rovira, Rovira-Gols, Grivé, and Alonso) and Liver Unit (Department of Internal Medicine) (Drs. Córdoba and Sanpedro), Hospital Universitari Vall d’Hebron, Barcelona, Spain.

Address correspondence and reprint requests to Dr. A. Rovira-Cañellas, Magnetic Resonance Unit (Department of Radiology), Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; e-mail: alex.rovira{at}idi-cat.org

Objective: To determine whether edema can be assessed by MRI using T2-weighted signal intensity of hemispheric white matter in cirrhotic patients.

Methods: Fast-FLAIR and magnetization transfer images were obtained before (24) and after (11) liver transplantation. T2-weighted abnormalities on baseline scans and their time-course changes were analyzed and compared with MT ratios (MTR).

Results: Fast-FLAIR baseline images showed faint to substantial, bilateral, symmetric increased signal intensity along the hemispheric white matter in or around the corticospinal tract in 23/24 patients. After liver transplantation the signal abnormalities gradually recovered. This gradual decrease in signal intensity correlated with an increase in MTR values.

Conclusion: Asymptomatic symmetric high-signal intensity in the hemispheric white matter on fast-FLAIR MR images is present in cirrhosis. Normalization of this finding after successful liver transplantation and its correlation with MTR values suggest that this signal abnormality reflects mild edema.

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