TITLE

Proton Magnetic Resonance Spectroscopy (1H-MRS) Findings for the Brain in Patients With Liver Cirrhosis Reflect the Hepatic Functional Reserve

AUTHOR(S)
Jung Hee Lee; Dong Wan Seo; Yung-Sang Lee; Sang-Tae Kim; Chi-Woong Mun; Tae-Hwan Lim; Young II Min; Dong-Jin Suh
PUB. DATE
August 1999
SOURCE
American Journal of Gastroenterology;Aug1999, Vol. 94 Issue 8, p2206
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: Proton magnetic resonance spectroscopy (¹H-MRS) has been used to assess the metabolic changes in the brain in patients with liver cirrhosis. Decreased myo-inositol and increased glutamine levels were noted to be the most sensitive spectroscopic markers for cirrhotic patients with hepatic encephalopathy (HE). The purpose of this study was to assess how the abnormalities seen on the ¹H-MRS of the brain in patients with liver cirrhosis are related to clinical and laboratory parameters. METHODS: In a prospective study, localized ¹H-MRS was performed in the basal ganglia and parietal white matter regions in liver cirrhosis patients with (n = 48) and without (n = 52) HE and chronic hepatitis (CH) (n = 15), and in normal controls (n = 20). RESULTS: Among cirrhotic patients, the myo-inositol levels were significantly lower (p < 0.01) and the glutamine levels were higher (p < 0.05) for patients with HE than for those without HE. The myo-inositol and glutamine levels, respectively, were inversely (r = -0.50; p < 0.001) and linearly (r = 0.50; p < 0.001) related to the Child-Pugh score. However, by subgroup analysis of Child-Pugh class C patients, there were no significant differences in the myoinositol and glutamine levels between cirrhotic patients with (n = 40) and without HE (n = 24). A follow-up study of eight cirrhotic patients with HE showed no significant differences in the myoinositol and glutamine levels after clinical improvement of HE. CONCLUSIONS: The abnormalities seen on the ¹H-MRS of the brain of patients with liver cirrhosis are not likely to reflect the severity of HE or acute alteration in the level of consciousness. Rather, we believe they represent the chronic metabolic derangement of the brain associated with hepatic functional reserve.
ACCESSION #
17830870

 

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