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Cerebral Phosphorus‐31 magnetic resonance spectroscopy in patients with chronic hepatic encephalopathy
Author(s) -
TaylorRobinson Simon D.,
Sargentoni Janet,
Mallalieu Rosemary J.,
Bell Jimmy D.,
Bryant David J.,
Coutts Glyn A.,
Morgan Marsha Y.
Publication year - 1994
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840200511
Subject(s) - hepatic encephalopathy , magnetic resonance imaging , nuclear magnetic resonance , phosphorus , nuclear magnetic resonance spectroscopy , medicine , spectroscopy , encephalopathy , gastroenterology , materials science , radiology , physics , cirrhosis , metallurgy , quantum mechanics
Cerebral phosphorus‐31 magnetic resonance spectroscopy was undertaken in 33 patients with biopsyproven cirrhosis: 6 had no evidence of neuropsychiatric impairment on standard clinical, psychometric and electrophysiological testing; 8 had evidence of subclinical hepatic encephalopathy; and 19 were classified as having overt hepatic encephalopathy. The reference population comprised 15 healthy volunteers. Unlocalized spectra were acquired from the entire head with a 45‐degree pulse angle and repetition times of 1 and 5 sec. Spectra localized to the basal ganglia were acquired with a 45‐degree pulse angle and a repetition time of 1 sec. Peak area ratios of phosphomonoesters, inorganic phosphate, phosphodiesters and phosphocreatine relative to β‐ATP were measured in the spectra acquired. We noted no consistent change in the ratios of inorganic phosphate to ATP and phosphocreatine to ATP. Mean values of the ratios of phosphomonoesters to ATP and phosphodiesters to ATP were significantly lower in the total patient population than in the reference population, and they correlated with the patients' neuropsychiatric status. Thus we found no significant reductions in the mean ratios of phosphomonoesters to ATP and phosphodiesters to ATP in patients who were neuropsychiatrically unimpaired, but significant reductions were observed in the mean ratios of phosphomonoesters to ATP and phosphodiesters to ATP in patients with both subclinical and overt hepatic encephalopathy. The most marked reductions in these metabolite ratios were observed in patients with overt encephalopathy. (Hepatology 1994;20:1173–1178).