| Two-dimensional MR spectroscopy of minimal hepatic encephalopathy and neuropsychological correlates in vivo. | |
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MedLine Citation:
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PMID: 20578008 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate regional cerebral metabolic and structural changes in patients with minimal hepatic encephalopathy (MHE) using two-dimensional (2D) MR spectroscopy (MRS) and T( (1) )-weighted MRI, to correlate the observed MR changes with neuropsychological (NP) test scores, and to compare the diagnostic accuracy of MRI, 2D MRS, and NP tests in discriminating between patients and healthy subjects. MATERIALS AND METHODS: Thirty-three MHE patients and 30 healthy controls were investigated. The 2D localized correlated spectroscopy (L-COSY) was performed in the frontal and occipital brain on a 1.5 Tesla (T) MR scanner. The NP test battery included 15 tests, grouped into 6 cognitive domains. Globus pallidus signal intensities were calculated from T(1)-weighted images. RESULTS: The 2D MRS showed significant differences in ratios of the following metabolite(s) peaks with respect to creatine (Cr): decreased myo-inositol (mI), choline (Ch), mICh, and increased (glutamate plus glutamine) (Glx) in patients compared with healthy subjects in both occipital and frontal lobes. Frontal lobe taurine also showed a decline in patients. The NP test results revealed declines in cognitive speed, motor function, executive function, and global cognitive status. Significant correlations were found between the altered metabolites and NP tests. Alteration in the mICh/Cr ratio was noted as a powerful discriminant between healthy subjects and the patients. CONCLUSION: The study demonstrates that relative metabolite levels determined by 2D MRS, in particular mICh/Cr, provide the best diagnostic prediction for MHE. The results suggest that depletions of myo-inositol, choline and taurine with respect to creatine correlate with measures of neuropsychological impairment. |
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Authors:
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Aparna Singhal; Rajakumar Nagarajan; Charles H Hinkin; Rajesh Kumar; James Sayre; Virginia Elderkin-Thompson; Amir Huda; Rakesh K Gupta; Steven-Huy Han; M Albert Thomas |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of magnetic resonance imaging : JMRI Volume: 32 ISSN: 1522-2586 ISO Abbreviation: J Magn Reson Imaging Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-29 Completed Date: 2010-10-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9105850 Medline TA: J Magn Reson Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 35-43 Citation Subset: IM |
Copyright Information:
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(c) 2010 Wiley-Liss, Inc. |
Affiliation:
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Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1721, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Hepatic Encephalopathy / metabolism*, pathology Humans Image Processing, Computer-Assisted / methods Liver / metabolism, pathology Magnetic Resonance Spectroscopy / methods* Male Middle Aged Neuropsychological Tests / statistics & numerical data* Predictive Value of Tests Reproducibility of Results Sensitivity and Specificity |
| Grant Support | |
ID/Acronym/Agency:
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1R01MH06569501A1/MH/NIMH NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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