Proton MR spectroscopy of the brain in patients treated with TIPS.
OBJECTIVE
To evaluate the utility of proton MR spectroscopy (MRS) for the early detection of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunting (TIPS).


METHODS
Six patients, who underwent TIPS for treatment of portal hypertension, were examined by MRS I week before and 1 week after TIPS. They were simultaneously clinically examined for number connection test, blood NH3 level, liver function test and the Fischer ratio.


RESULTS
Three of 6 patients showed overt HE 1 to 5 weeks after TIPS and the other 3 patients did not show overt HE. The overt HE group showed the larger ratio of the amounts of glutamine and glutamate/myo-inositol (Glx/MI) than that of non-overt HE group (p<0.05).


CONCLUSIONS
The Glx/MI ratio estimated by MRS was useful for early detection of HE after TIPS.
Hamuro
M
M
Department of Radiology, Osaka City University Medical School, Osaka, Japan.
Nakamura
K
K
Matsuoka
T
T
Kaminou
T
T
Higashida
M
M
Yamada
R
R
D000328:Adult; D000368:Aged; D001923:Brain Chemistry; D005260:Female; D018698:Glutamic Acid / Q000032:analysis; D005973:Glutamine / Q000032:analysis; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D007294:Inositol / Q000032:analysis; D008111:Liver Function Tests; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*
D005973:Glutamine; D018698:Glutamic Acid; D007294:Inositol