SUBCLINICAL HEPATIC-ENCEPHALOPATHY - PROTON MR SPECTROSCOPIC ABNORMALITIES

被引:183
作者
ROSS, BD
JACOBSON, S
VILLAMIL, F
KORULA, J
KREIS, R
ERNST, T
SHONK, T
MOATS, RA
机构
[1] UNIV CALIF LOS ANGELES, INST NEUROPSYCHIAT, LOS ANGELES, CA 90024 USA
[2] CEDARS SINAI MED CTR, DEPT TRANSPLANT SERV, LOS ANGELES, CA USA
[3] UNIV SO CALIF, DEPT MED, LOS ANGELES, CA USA
[4] UNIV SO CALIF, DEPT GASTROENTEROL, LOS ANGELES, CA USA
[5] RANCHO LOS AMIGOS MED CTR, DEPT GASTROENTEROL, LOS ANGELES, CA USA
关键词
BRAIN; DISEASES; MR; LIVER; CIRRHOSIS; MAGNETIC RESONANCE (MR); SPECTROSCOPY;
D O I
10.1148/radiology.193.2.7972763
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To determine whether hydrogen-1 magnetic resonance (MR) spectroscopy MATERIALS AND METHODS: In a double-blind study, overt hepatic encephalopathy (HE) and SCHE (defined with clinical and neuropsychiatric tests) were compared by means of H-1 MR spectroscopic criteria-reduction in cerebral myo-inositol (<2 standard deviations [SDs] from normal) and choline (<2 SDs from normal) with or without increased cerebral glutamine (>1 SD from normal)-in 20 patients with cirrhosis. RESULTS: Concordance between MR spectroscopic and neuropsychiatric test results was 94% (kappa = 0.84). MR spectroscopy allowed diagnosis of SCHE in nine of nine patients (100%) and of HE in seven of eight (88%). Myo-inositol depletion alone had 80%-85% sensitivity for detection of HE and SCHE. CONCLUSION: H-1 MR spectroscopy allows accurate diagnosis of SCHE, and the results suggest an important role for myo-inositol in psychomotor and visuopractic functions.
引用
收藏
页码:457 / 463
页数:7
相关论文
共 51 条
[1]   CHANGES IN NAMING ABILITY WITH AGE [J].
ALBERT, MS ;
HELLER, HS ;
MILBERG, W .
PSYCHOLOGY AND AGING, 1988, 3 (02) :173-178
[2]  
[Anonymous], 1991, PROFILE TEST RESULTS
[3]   TRAILMAKING AND NUMBER-CONNECTION TESTS IN ASSESSMENT OF MENTAL STATE IN PORTAL SYSTEMIC ENCEPHALOPATHY [J].
CONN, HO .
AMERICAN JOURNAL OF DIGESTIVE DISEASES, 1977, 22 (06) :541-550
[4]  
DIXON WJ, 1990, BMDP STATISTICAL SOF, V1
[5]   ENCEPHALOPATHY IN PATIENTS WITH CIRRHOSIS OF LIVER - NEUROPSYCHOLOGICAL STUDY [J].
ELSASS, P ;
LUND, Y ;
RANEK, L .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1978, 13 (02) :241-247
[6]   ABSOLUTE QUANTITATION OF WATER AND METABOLITES IN THE HUMAN BRAIN .1. COMPARTMENTS AND WATER [J].
ERNST, T ;
KREIS, R ;
ROSS, BD .
JOURNAL OF MAGNETIC RESONANCE SERIES B, 1993, 102 (01) :1-8
[7]   CEREBRAL MRS IN INFANT WITH SUSPECTED REYES-SYNDROME [J].
ERNST, T ;
ROSS, BD ;
FLORES, R .
LANCET, 1992, 340 (8817) :486-486
[8]  
ERNST T, 1993, P SOC MAGNETIC RESON, P323
[9]   MINI-MENTAL STATE - PRACTICAL METHOD FOR GRADING COGNITIVE STATE OF PATIENTS FOR CLINICIAN [J].
FOLSTEIN, MF ;
FOLSTEIN, SE ;
MCHUGH, PR .
JOURNAL OF PSYCHIATRIC RESEARCH, 1975, 12 (03) :189-198
[10]  
GEISSLER A, 1992, 11TH P ANN SCI M SOC, P647