title: Adding another spectral dimension to 1H magnetic resonance spectroscopy of hepatic encephalopathy.
abstract: OBJECTIVE
  To evaluate a localized two-dimensional correlated magnetic resonance spectroscopic (L-COSY) technique in patients with hepatic encephalopathy (HE) and healthy subjects, and to correlate the cerebral metabolite changes with neuropsychological (NP) test scores.
  
  
  METHODS
  Eighteen minimal hepatic encephalopathy (MHE) patients and 21 healthy controls have been investigated. A GE 1.5-T magnetic resonance (MR) scanner was used in combination with a body MR coil for transmission and a 3-inch surface coil for reception. A 27-mL voxel was localized by three slice-selective radio frequency (RF) pulses (90 degrees-180 degrees-90 degrees) in the anterior cingulate region. The total duration of each two-dimensional L-COSY spectrum was approximately 25 minutes. The NP battery included a total of 15 tests, which were grouped into six domains.
  
  
  RESULTS
  MR spectroscopic results showed a statistically significant decrease in myo-inositol (mI) and choline (Ch) and an increase in glutamate/glutamine (Glx) in patients when compared to healthy controls. There was also an increase in taurine (Tau) in patients. The NP results indicated a significant correlation between motor function assessed by NP tests and mI ratios recorded using two-dimensional L-COSY.
  
  
  CONCLUSIONS
  The study demonstrated the feasibility of evaluating the two-dimensional L-COSY sequence in a clinical environment. The results showed additional cerebral metabolites that can be measured with the technique in comparison to one-dimensional study.
authors.affiliation: Department of Radiological Science, David Geffen School of Medicine at University of California, Los Angeles, California 90024-1721, USA. nbinesh@mednet.ucla.ede
authors.forename: Nader
authors.initials: N
authors.lastname: Binesh
authors.forename: Amir
authors.initials: A
authors.lastname: Huda
authors.forename: Mary
authors.initials: M
authors.lastname: Bugbee
authors.forename: Rakesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Natalie
authors.initials: N
authors.lastname: Rasgon
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.forename: Michael
authors.initials: M
authors.lastname: Green
authors.forename: Steven
authors.initials: S
authors.lastname: Han
authors.forename: M Albert
authors.initials: MA
authors.lastname: Thomas
mesh_terms: D001921:Brain / Q000378:metabolism; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000032:analysis; D006501:Hepatic Encephalopathy / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D005973:Glutamine; D018698:Glutamic Acid