Evaluation of mannitol effect in patients with acute hepatic failure and acute-on-chronic liver failure using conventional MRI, diffusion tensor imaging and in-vivo proton MR spectroscopy

Table 5 Peak integrals relative to those of creatine (mean ± SD) in right parietal white and gray matter in healthy controls, acute liver failure (ALF) patients and acute-on-chronic liver failure (ACLF) patients before the intravenous infusion of mannitol (pre-mannitol study) and after receiving mannitol (post-mannitol study)

Metabolites	Study
	Control (n = 5)			ALF patient (n = 5)			ACLF patient (n = 5)
	Pre-mannitol	Post-mannitol	P	Pre-mannitol	Post-mannitol	P	Pre-mannitol	Post-mannitol	P
NAA/Cr	1.25 ± 0.16	1.23 ± 0.17	0.92	1.20 ± 0.13	1.27 ± 0.32	0.75	0.90 ± 0.35	0.58 ± 0.29	0.18
Cho/Cr	0.24 ± 0.06	0.24 ± 0.08	0.75	0.18 ± 0.09	0.16 ± 0.07	0.47	0.20 ± 0.05	0.20 ± 0.03	0.75
Gln/Cr	1.44 ± 1.06	1.18 ± 0.94	0.35	3.04 ± 1.32	2.52 ± 1.56	0.25	1.44 ± 0.30	2.42 ± 1.44	0.60
Glx/Cr	2.84 ± 0.98	2.70 ± 1.21	0.60	4.46 ± 1.48	4.38 ± 1.61	0.92	2.85 ± 0.70	3.85 ± 2.13	0.35
mI/Cr	0.57 ± 0.48	0.49 ± 0.34	0.92	0.56 ± 0.15	0.47 ± 0.16	0.18	0.41 ± 0.17	0.89 ± 1.14	0.81

Cr: Creatine; NAA: N-acetylaspartate; Cho: Choline; Gln: Glutamine; Glx: Glutamine/glutamate; mI: Myoinositol.