Proton MR spectroscopy of the brain in patients treated with TIPS

Acta Radiol. 2000 Nov;41(6):567-71. doi: 10.1080/028418500127345910.

Abstract

Purpose: To evaluate the utility of proton MR spectroscopy (MRS) for the early detection of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunting (TIPS).

Material and methods: Six patients, who underwent TIPS for treatment of portal hypertension, were examined by MRS I week before and 1 week after TIPS. They were simultaneously clinically examined for number connection test, blood NH3 level, liver function test and the Fischer ratio.

Result: Three of 6 patients showed overt HE 1 to 5 weeks after TIPS and the other 3 patients did not show overt HE. The overt HE group showed the larger ratio of the amounts of glutamine and glutamate/myo-inositol (Glx/MI) than that of non-overt HE group (p<0.05).

Conclusion: The Glx/MI ratio estimated by MRS was useful for early detection of HE after TIPS.

MeSH terms

  • Adult
  • Aged
  • Brain Chemistry*
  • Female
  • Glutamic Acid / analysis
  • Glutamine / analysis
  • Hepatic Encephalopathy / diagnosis*
  • Hepatic Encephalopathy / etiology
  • Humans
  • Hypertension, Portal / surgery
  • Inositol / analysis
  • Liver Function Tests
  • Magnetic Resonance Spectroscopy*
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*

Substances

  • Glutamine
  • Glutamic Acid
  • Inositol