Proton Magnetic Resonance Spectroscopic Study Of Cerebral Metabolic Changes In Patients With Chronic Hepatic Cirrhosis

Objective: To study the metabolic alterations in the brain of patients withchronic hepatic cirrhosis and the features of chronic hepatic encephalopathy(CHE) with proton magnetic resonance spectroscopy (~1H-MRS) for betterunderstanding the role in the diagnosis of CHE and the pathophysiology ofCHE.Methods:3.0T1H-MRS in30patients (24males,6females；19patientswith chronic hepatic cirrhosis in decompensatory period,11patients withchronic hepatic encephalopathy) were studied.20age-matched healthyvolunteers (16males,4females) underwent~1H-MRS for comparison. The areaof resonance peaks of different metabolites（NAA、 Cho、Cr、mI、 Glx） wasmeasured. The ratio of areas under peak of these cerebral metabolites and Cr(NAA/Cr, Cho/Cr, mI/Cr, Glx/Cr) have been calculated and analyzed,respectively.Results： In patients with severe cirrhosis (in decompensatory period)and CHE, the mean values of mI/Cr and Cho/Cr ratio were significantly lowerthan those in healthy volunteers (P <0.05). The mean values of Glx/Crratio showed no statistical difference between severe cirrhosis and the controlgroup(P>0.05)，but the mean value of Glx/Cr ratio in patients with CHEwas significantly higher than that in the control group (P<0.05). The Glx/Crratio in patients with CHE was higher than that in patients with severe cirrhosis(P <0.05)，but mI/Cr、Cho/Cr ratios were no significant differences (P>0.05). NAA/Cr levels showed no statistical difference among patients with CHEand patients with chronic hepatic cirrhosis and the control group (P>0.05).Conclusions: 1、There were cerebral metabolic changes in patients with chronic hepaticcirrhosis and CHE.2、1H-MRS is reliable techniques in the diagnosis for chronic hepaticencephalopathy.3、1H-MRS can demonstrate brain metabolic changes in patients withchronic hepatic cirrhosis in vivo noninvasively, thereby helping interpret thepathophysiology of CHE.