Does magnetic resonance spectroscopy identify patients with minimal hepatic encephalopathy?

Irena Ciećko-Michalska; Tomasz Dziedzic; Robert Banyś; Magdalena Senderecka; Marek Binder; Mirosław Wyczesany; Jakub Szewczyk; Jan Wójcik; Agnieszka Słowik; Tomasz Mach

doi:10.5114/ninp.2012.31353

Vol 46, No 5 (2012)

ARTYKUŁ ORYGINALNY

Submitted: 2011-12-22

View PDF

Download PDF file

Get Citation

Does magnetic resonance spectroscopy identify patients with minimal hepatic encephalopathy?

Irena Ciećko-Michalska¹, Tomasz Dziedzic², Robert Banyś³, Magdalena Senderecka⁴, Marek Binder⁴, Mirosław Wyczesany⁴, Jakub Szewczyk⁴, Jan Wójcik⁴, Agnieszka Słowik⁴, Tomasz Mach¹

DOI: 10.5114/ninp.2012.31353

Neurol Neurochir Pol 2012;46(5):436-442.

Affiliations

3. Department of Gastroenterology with Endoscopic Subunit, Medical University of Lublin, Poland
1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Inter nal Medicine and Car diology with the Center for Diagnosis and T reatment of Venous Thromboembolism, Medical University of Warsaw, Poland
Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow

Vol 46, No 5 (2012)

ARTYKUŁ ORYGINALNY

Submitted: 2011-12-22

Abstract

Background and purpose

The results of a few studies suggest that magnetic resonance spectroscopy of the brain could allow detection of minimal hepatic encephalopathy. The goal of this study was to assess the ability of magnetic resonance spectroscopy to differentiate between cirrhotic patients with and without minimal hepatic encephalopathy.

Material and methods

Localized magnetic resonance spectroscopy was performed in the basal ganglia, occipital gray matter and frontal white matter in 46 patients with liver cirrhosis without overt encephalopathy and in 45 controls. Neurological and neuropsychological examination was performed in each participant.

Results

The patients with liver cirrhosis had a decreased ratio of myoinositol to creatine in occipital gray matter and frontal white matter (mean: 0.17 ± 0.05 vs. 0.20 ± 0.04, p = 0.01 and 0.15 ± 0.05 vs. 0.19 ± 0.04, p < 0.01, respectively) and a decreased ratio of choline to creatine in occipital gray matter (mean: 0.32 ± 0.07 vs. 0.36 ± 0.08, p = 0.03). Minimal hepatic encephalopathy was diagnosed in 7 patients. Metabolite ratios did not differ significantly between patients with and without minimal hepatic encephalopathy. Metabolite ratios did not differ significantly between patients with Child-Pugh A and those with Child-Pugh B.

Conclusions

Magnetic resonance spectroscopy does not allow accurate diagnosis of minimal hepatic encephalopathy. A similar profile of metabolites in the brain is observed in cirrhotic patients without cognitive impairment.