title: Viability assessment of magnetic resonance spectroscopy for the detection of minimal hepatic encephalopathy severity.
abstract: OBJECTIVE
  To evaluate regional cerebral metabolic changes in minimal hepatic encephalopathy (MHE) patients using magnetic resonance spectroscopy (MRS) in 3T scanner.
  
  
  METHODS
  This study comprised 30 cirrhotic patients with MHE, 29 cirrhotic patients without MHE and 30 healthy volunteers. Single-voxel proton MRS data in the anterior cingulate cortex (ACC) and basal ganglia were acquired using a 3-T scanner. The concentrations of N-acetylaspartate (NAA), mI (myo-inositol), glutamate (Glu), glutamine (Gln) and creatine (Cr) were obtained by LC-model software. Statistical analysis was performed to evaluate the differences between the three groups.
  
  
  RESULTS
  There was a significant increase in Glu for the cirrhotic patients, particularly the MHE patients. There was an elevation of Gln in the cirrhotic patients, but not in all cirrhotic patients or controls. There was a significant decrease in mI for the cirrhotic patients, but no significant difference between the two cirrhosis groups. There was no significant difference in NAA between the three groups.
  
  
  CONCLUSIONS
  MRS using a 3-T MR scanner could detect cerebral metabolic changes in cirrhotic patients with MHE. Glu levels were elevated in cirrhotic patients with MHE; Glu levels could be used as a sensitive indicator to evaluate the severity of MHE in patients with cirrhosis.
authors.affiliation: Department of Radiology, Jinshan Branch of Shanghai No. 6 People's Hospital, No.147 Jian Kang Road, Shanghai, China.
authors.forename: Ling-Ping
authors.initials: LP
authors.lastname: Meng
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai, China.
authors.forename: Yuan-Chang
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai, China. Electronic address: li_yue_hua@126.com.
authors.forename: Yue-Hua
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai, China.
authors.forename: Jin-Shui
authors.initials: JS
authors.lastname: Zhu
authors.affiliation: Department of Psychiatry, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai, China.
authors.forename: Jian-Lin
authors.initials: JL
authors.lastname: Ye
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001479:Basal Ganglia / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D003071:Cognition / Q000502:physiology; D003401:Creatine / Q000032:analysis; D005260:Female; D018698:Glutamic Acid / Q000032:analysis; D005973:Glutamine / Q000032:analysis; D006179:Gyrus Cinguli / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D006505:Hepatitis / Q000378:metabolism; D006801:Humans; D007294:Inositol / Q000032:analysis; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000378:metabolism; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
chemical_list: D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine
keywords: Anterior cingulate cortex; Basal ganglia; Hepatic cirrhosis; Magnetic resonance spectroscopy; Minimal hepatic encephalopathy