[Myoinositol trends in HMRS brain spectrum of patients with hepatic encephalopathy].
Hepatic encephalopathy (HE) comprises a complex set of neuropsychiatric abnormalities upon primary hepatic dysfunction. Ammonia and other nitrogen-based compounds are thought to be essential etiological factors when dysmetabolized in the liver, they provoke highly undesirable neuroglial transmission in the central nervous system (CNS). Proton MR spectroscopy (HMRS) is a noninvasive in vivo method of analyzing the metabolic spectrum of neuronal tissue and its pathological changes even before overt clinical symptoms occur and can be seen in morphological MR examination. Myoinositol (ml) is one of the metabolites that can be identified with HMRS. It is considered a glial marker, directly involved in compensation processes to overcome toxic effects of hepatic metabolites which had crossed the brain-blood barrier. Thus, ml may be a crucial prognostic factor for patients with HE. The goal of the present paper was to selectively investigate ml trends upon the MR brain spectrum. 36 male participants were enrolled in the study: 20 patients (mean age 58.2 years) with clinical symptoms suggestive of HE in the course of either chronic viral hepatitis or post-viral liver cirrhosis, and 16 men (mean age 51.3 years) with normal liver function (control group). Brain MR examinations were performed in all participants, followed by HMRS in single voxel spectroscopy (SVS) technique from occipital gray matter of right (Voxel 1) and left (Voxel 2) cerebral hemispheres. MR data were acquired with a 1.5 T GE Signa Excite scanner. ml peak height was normalized with respect to creatine. A statistically significant decrease in ml/Cr ratio has been appreciated in the MR spectra of HE patients. The mean ml/Cr ratio for HE patients was 0.75, and was 0.93 for the control group, and, for alpha = 0.05, the observed differences between ml/Cr ratio mean values appeared to be statistically significant.
Herman-Sucharska
Izabela
I
Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum, Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie. radiologia@su.krakow.pl
Grzybek
Magdalena
M
Grochowska
Anna
A
Karcz
Paulina
P
Urbanik
Andrzej
A
D000641:Ammonia / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000378:metabolism*; D008099:Liver / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009457:Neuroglia / Q000378:metabolism; D009778:Occipital Lobe / Q000378:metabolism*
D015415:Biomarkers; D007294:Inositol; D000641:Ammonia; D003401:Creatine; D002794:Choline