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Title: Usefulness of cerebral proton MR spectroscopy (1HMRS) in the diagnosis of minimal hepatic encephalopathy in adult patients with chronic viral hepatitis


This study focuses on the analysis of metabolic disturbances in cerebral 1HMRS in adult patients with chronic viral hepatitis in correlation with blood ammonia levels and the results of neuropsychological assessment to identify individuals with MHE. 1,5T MR scanner was used to examine 46 patients (14 with post-viral cirrhosis) and 25 healthy controls. Relative metabolic concentrations (NAA/Cr, Cho/Cr, mI/Cr, Glx/Cr, Lip/Cr, Lac/Cr) were calculated from 4 voxels: basal ganglia, parietal lobe (WM), frontal and occipital lobes (GM). All patients were screened to assess blood ammonia levels. All participants underwent a battery of neuropsychological tests: MMSE, NCT-A/B, VF-1/2, mental rotation, Rey memory test. The following statistically significant changes were observed: increase of Glx/Cr in basal ganglia and occipital GM, decrease of mI/Cr in parietal WM, increase of Lac/Cr in both occipital and frontal GM, increase of NAA/Cr in parietal WM in patients with cirrhosis (group II). A tendency to increase Glx/Cr in parietal WM in group II and to increase Cho/Cr in patients without cirrhosis (group I) was also noted. In patients from group II mean ammonia concentration was higher than in group I. Negative correlations were detected between the ammonia level and the following relative values: Lac/Cr in frontal GM (group I) and mI/Cr in occipital GM and Cho/Cr in parietal WM and fron ; tal GM (group II). No statistically important changes were reported considering the psychological tests. With the use of 1HMRS, metabolic abnormalities were observed in WM and GM, both deep and cortical, in patients with chronic viral hepatitis.

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Level of degree:

2 - studia doktoranckie

Degree discipline:

radiologia ; neurologia ; choroby zakaźne

Degree grantor:

Wydział Lekarski


Urbanik, Andrzej

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tylko w bibliotece

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Last modified:

Mar 13, 2023

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May 8, 2013

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Edition name Date
ZB-118168 Mar 13, 2023


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