Role of cerebral blood flow changes in post-transjugular intrahepatic portosystemic shunts hepatic encephalopathy

Figure 1 Flow chart of patient selection. TIPS: Transjugular intrahepatic portosystemic shunts; MRI: Magnetic resonance imaging.

Figure 2 Regions with significant differences showing cerebral blood flow. The color bar represents the t-values between the two groups after post hoc verification; the higher the brightness of the color, the more significant the difference. The red area indicates regions where amplitude of low-frequency fluctuation values is increased, and the blue area indicates regions where amplitude of low-frequency fluctuation values is decreased. X and Z = three-dimensional coordinates of brain structures. Before: Preoperative transjugular intrahepatic portosystemic shunts; HC: Healthy control group; 1 m: Postoperative transjugular intrahepatic portosystemic shunts at 1 month; 3 m: Postoperative transjugular intrahepatic portosystemic shunts at 3 months.

Figure 3 Regions with significant differences showing amplitude of low-frequency fluctuation. X and Z = three-dimensional coordinates of brain structures. Before: Preoperative transjugular intrahepatic portosystemic shunts; HC: Healthy control group; 1 m: Postoperative transjugular intrahepatic portosystemic shunts at 1 month; 3 m: Postoperative transjugular intrahepatic portosystemic shunts at 3 months.

Figure 4 Correlations between the changes of cerebral blood flow and amplitude of low-frequency fluctuation with the changes of clinical indicators (Number Connection Test Part A scores; Digit Symbol Substitution Test scores; Child-Pugh scores; portal pressure). A: ΔChild-Pugh score; B: ΔNumber Connection Test Part A scores; C: ΔPortal pressure; D: ΔDigit Symbol Substitution Test scores. r: P < 0.05 was the result of Pearson correlation analysis; R: P < 0.05 was the result of Spearman’s correlation analysis. CBF: Cerebral blood flow; NCT-A: Number Connection Test Part A; ALFF: Amplitude of low-frequency fluctuation; DSST: Digit Symbol Substitution Test.