Cordoba J, Hinojosa C, Sampedro F, Alonso J, Rovira A, Quiroga S, Esteban R, Guardia J
Servicio de Medicina Interna-Hepatología, Unidad de Resonancia Magnética, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Dig Dis Sci. 2001 Nov;46(11):2451-5. doi: 10.1023/a:1012323819757.
Magnetic resonance spectroscopy allows the assessment of several metabolites in brain tissue. In patients with hepatic encephalopathy, this technique shows a rise in glutamine and a decrease in myoinositol in brain tissue. However, the role of magnetic resonance spectroscopy in the diagnosis of hepatic encephalopathy is not known. We report the case of a patient with a relapsing confusional syndrome who underwent magnetic resonance spectroscopy. Previously, hepatic encephalopathy was ruled out because of the negative results of a transjugular liver biopsy and normal hepatic venous pressure gradient. The results of magnetic resonance were characteristic of hepatic encephalopathy. Abdominal computed tomography demonstrated large portosystemic shunts associated with cirrhosis of the liver. This case shows that magnetic resonance spectroscopy is an useful technique for the diagnosis of hepatic encephalopathy in selected cases, such as those without clinical signs of cirrhosis and/or large portosystemic shunts.
磁共振波谱分析可用于评估脑组织中的多种代谢物。在肝性脑病患者中，该技术显示脑组织中谷氨酰胺升高而肌醇降低。然而，磁共振波谱分析在肝性脑病诊断中的作用尚不清楚。我们报告了一例复发性意识模糊综合征患者接受磁共振波谱分析的病例。此前，由于经颈静脉肝活检结果为阴性且肝静脉压力梯度正常，肝性脑病被排除。磁共振结果具有肝性脑病的特征。腹部计算机断层扫描显示存在与肝硬化相关的大量门体分流。该病例表明，磁共振波谱分析在某些特定病例中是诊断肝性脑病的有用技术，例如那些没有肝硬化临床体征和/或大量门体分流的病例。
