open access

Vol 46, No 5 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2011-12-22
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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
·
Neurol Neurochir Pol 2012;46(5):436-442.

open access

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.

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.

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Keywords

magnetic resonance spectroscopy, minimal hepatic encephalopathy, liver cirrhosis, neuropsychological assessment

About this article
Title

Does magnetic resonance spectroscopy identify patients with minimal hepatic encephalopathy?

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 5 (2012)

Pages

436-442

DOI

10.5114/ninp.2012.31353

Bibliographic record

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

Keywords

magnetic resonance spectroscopy
minimal hepatic encephalopathy
liver cirrhosis
neuropsychological assessment

Authors

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

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