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• Clinical Article •
Viability assessment of magnetic resonance spectroscopy for the detection of minimal hepatic encephalopathy severity
HUANG Tian-yu  LIANG Ying-liang  WANG Song  YAO Ye 

DOI:10.12015/issn.1674-8034.2017.06.003.


[Abstract] Objective: To evaluate regional cerebral metabolic changes in minimal hepatic encephalopathy (MHE) patients using magnetic resonance spectroscopy (MRS) in 3.0 T scanner.Materials and Methods: This study comprised 30 cirrhotic patients with MHE, 29 cirrhotic patients without MHE and 30 healthy volunteers. Single-voxel proton MRS data in the anterior cingulate cortex (ACC) and basal ganglia were acquired using a 3.0 T scanner. The concentrations of N-acetylaspartate (NAA), myo-inositol (MI), glutamate (Glu), glutamine (Gln) and creatine (Cr) were obtained by LC-model software. Statistical analysis was performed to evaluate the differences between the three groups.Results: There was a significant increase in Glu for the cirrhotic patients, particularly the MHE patients. There was an elevation of Gln in the cirrhotic patients, but not in all cirrhotic patients or controls. There was a significant decrease in MI for the cirrhotic patients, but no significant difference between the two cirrhosis groups. There was no significant difference in NAA between the three groups.Conclusion: MRS using a 3.0 T MR scanner could detect cerebral metabolic changes in cirrhotic patients with MHE. Glu levels were elevated in cirrhotic patients with MHE; Glu levels could be used as a sensitive indicator to evaluate the severity of MHE in patients with cirrhosis.
[Keywords] Magnetic resonance spectroscopy；Hepatic encephalopathy；Liver cirrhosis；Magnetic resonance imaging

HUANG Tian-yu LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

LIANG Ying-liang LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

WANG Song LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

YAO Ye* LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

*Correspondence to: Yao Y, E-mail: 122186836@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning No.201540198
Received  2017-02-28
Accepted  2017-05-09
DOI: 10.12015/issn.1674-8034.2017.06.003
DOI:10.12015/issn.1674-8034.2017.06.003.

[1]
Zhan T, Stremmel W. The diagnosis and treatment of minimal hepaticencephalopathy, Dtsch. Arztebl Int, 2012, 109(10): 180-187.
[2]
Stinton LM, Jayakumar S. Minimal hepatic encephalopathy. Can J Gastroenterol, 2013, 27(10): 572-574.
[3]
Kappus MR, Bajaj JS. Covert hepatic encephalopathy: not as minimal as youmight think. Clin Gastroenterol Hepatol, 2012, 10(11): 1208-1219.
[4]
Mullen KD. Review of the final report of the 1998 working party on definition, nomenclature and diagnosis of hepatic encephalopathy. Aliment Pharmacol Ther, 2007, 25(Suppl): 11-16.
[5]
Stewart CA, Smith GE. Minimal hepatic encephalopathy. Nat Clin Pract Gastroenterol Hepatol, 2007, 4(12): 677-685.
[6]
Singhal A, Nagarajan R, Hinkin CH, et al. Two-dimensional MR spectroscopy of minimal hepatic encephalopathy and neuropsychological correlates in vivo. J Magn Reson Imaging, 2010, 32(1): 35-43.
[7]
Amodio P, Montagnese S, Gatta A, et al. Characteristics of minimalhepatic encephalopathy. Metab Brain Dis, 2004, 19(3): 253-267.
[8]
Foerster BR, Conklin LS, Petrou M, et al. Minimal hepatic encephalopathy in children: evaluation with proton MR spectroscopy. Am J Neuroradiol, 2009, 30(8): 1610-1613.
[9]
Baja JS, Cordoba J, Mullen KD, et al. Review article: the design of clinicaltrials in hepaticencephalopathy-aninternational society for hepatic encephalopathy and nitrogen metabolism(ISHEN) consensus statement. Aliment Pharmacol Ther, 2011, 33 (7): 739-747.
[10]
Savlan I, Liakina V, Valantinas J. Concise review of current concepts onnomenclature and pathophysiology of hepatic encephalopathy. Medicina (Kaunas), 2014, 50(2): 75-81.
[11]
Sturgeon JP, Shawcross DL. Recent insights into the pathogenesis of hepaticencephalopathy and treatments. Expert Rev Gastroenterol Hepatol, 2014, 8(1): 83-100.
[12]
Sturgeon JP, Shawcross DL. Recent insights into the pathogenesis of hepaticencephalopathy and treatments. Expert Rev Gastroenterol Hepatol, 2014, 8(1): 83-100.
[13]
Amodio P, Montagnese S, Gatta A, et al. Characteristics of minimalhepatic encephalopathy. Metab Brain Dis, 2004, 19(3): 253-267.
[14]
Weissenborn K, Ahl B, Fischer-Wasels D, et al. Correlations between magnetic resonance spectroscopyalterations and cerebral ammonia and glucose metabolism in cirrhoticpatients with and without hepatic encephalopathy. Gut, 2007, 56(12): 1736-1742.
[15]
Patidar KR, Bajaj JS. Covert and overt hepatic encephalopathy: diagnosis and management. Clin Gastroenterol Hepatol, 2015, 13(12): 2048-2061.
[16]
Suraweera D, Sundaram V, Saab S. Evaluation and management of hepatic encephalopathy: current status and future directions. Gut Liver, 2016, 10(4): 509-519.
[17]
Keiding S, Pavese N. Brain metabolism in patients with hepaticencephalopathy studied by PET and MR. Arch Biochem Biophys, 2013, 536(2): 131-142.

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