Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood

Santosh K. Yadav, S. Saksena, Anshu Srivastava, Arti Srivastava, V. A. Saraswat, M. A. Thomas, R. K.S. Rathore, Rakesh K. Gupta

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: MR imaging and 1H-MR spectroscopy changes are well reported in cirrhotic patients, whereas they are inadequately reported in EHPVO. The aim of this study was to investigate age-related changes in brain MR imaging and metabolite profile in EHPVO with and without MHE and to explore any correlation of imaging and 1H-MR spectroscopy parameters with blood ammonia. MATERIALS AND METHODS: Sixty-three patients with EHPVO (children, 7-12 years [n = 22], adolescents, 13-18 years [n = 15] and adults, 19-41 years [n = 26]) and 47 healthy age/sex-matched volunteers were studied. Neuropsychological tests, MR imaging, 1H-MR spectroscopy, and blood ammonia estimation were performed in all subjects. RESULTS: Of 63 EHPVO patients, 25 (40%) who had MHE showed significantly increased MD, Glx, and blood ammonia in all 3 age groups; however, myo-inositol was significantly lower only in adults when compared with controls. MD positively correlated with blood ammonia and Glx in all age groups. Brain choline levels were normal in all patients with different age groups. CONCLUSIONS: Increases in brain MD, Glx, and blood ammonia were associated with MHE in all age groups. Normal brain choline in EHPVO signifies healthy liver and may serve as a diagnostic marker for its differentiation from cirrhosis-induced encephalopathy. Significant decrease of myo-inositol in adults is probably due to cellular osmoregulation secondary to long-standing hyperammonemia.

Original languageEnglish
Pages (from-to)1337-1342
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume31
Issue number7
DOIs
Publication statusPublished - 1 Aug 2010
Externally publishedYes

Fingerprint

Portal Vein
Ammonia
Neuroimaging
Magnetic Resonance Spectroscopy
Age Groups
Inositol
Choline
Brain
Hyperammonemia
Osmoregulation
Neuropsychological Tests
Differentiation Antigens
Brain Diseases
Volunteers
Fibrosis
Liver

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood. / Yadav, Santosh K.; Saksena, S.; Srivastava, Anshu; Srivastava, Arti; Saraswat, V. A.; Thomas, M. A.; Rathore, R. K.S.; Gupta, Rakesh K.

In: American Journal of Neuroradiology, Vol. 31, No. 7, 01.08.2010, p. 1337-1342.

Research output: Contribution to journalArticle

Yadav, Santosh K. ; Saksena, S. ; Srivastava, Anshu ; Srivastava, Arti ; Saraswat, V. A. ; Thomas, M. A. ; Rathore, R. K.S. ; Gupta, Rakesh K. / Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood. In: American Journal of Neuroradiology. 2010 ; Vol. 31, No. 7. pp. 1337-1342.
@article{b0f8cfd0d338402c898ef8a62d612bc0,
title = "Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood",
abstract = "BACKGROUND AND PURPOSE: MR imaging and 1H-MR spectroscopy changes are well reported in cirrhotic patients, whereas they are inadequately reported in EHPVO. The aim of this study was to investigate age-related changes in brain MR imaging and metabolite profile in EHPVO with and without MHE and to explore any correlation of imaging and 1H-MR spectroscopy parameters with blood ammonia. MATERIALS AND METHODS: Sixty-three patients with EHPVO (children, 7-12 years [n = 22], adolescents, 13-18 years [n = 15] and adults, 19-41 years [n = 26]) and 47 healthy age/sex-matched volunteers were studied. Neuropsychological tests, MR imaging, 1H-MR spectroscopy, and blood ammonia estimation were performed in all subjects. RESULTS: Of 63 EHPVO patients, 25 (40{\%}) who had MHE showed significantly increased MD, Glx, and blood ammonia in all 3 age groups; however, myo-inositol was significantly lower only in adults when compared with controls. MD positively correlated with blood ammonia and Glx in all age groups. Brain choline levels were normal in all patients with different age groups. CONCLUSIONS: Increases in brain MD, Glx, and blood ammonia were associated with MHE in all age groups. Normal brain choline in EHPVO signifies healthy liver and may serve as a diagnostic marker for its differentiation from cirrhosis-induced encephalopathy. Significant decrease of myo-inositol in adults is probably due to cellular osmoregulation secondary to long-standing hyperammonemia.",
author = "Yadav, {Santosh K.} and S. Saksena and Anshu Srivastava and Arti Srivastava and Saraswat, {V. A.} and Thomas, {M. A.} and Rathore, {R. K.S.} and Gupta, {Rakesh K.}",
year = "2010",
month = "8",
day = "1",
doi = "10.3174/ajnr.A2045",
language = "English",
volume = "31",
pages = "1337--1342",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "7",

}

TY - JOUR

T1 - Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood

AU - Yadav, Santosh K.

AU - Saksena, S.

AU - Srivastava, Anshu

AU - Srivastava, Arti

AU - Saraswat, V. A.

AU - Thomas, M. A.

AU - Rathore, R. K.S.

AU - Gupta, Rakesh K.

PY - 2010/8/1

Y1 - 2010/8/1

N2 - BACKGROUND AND PURPOSE: MR imaging and 1H-MR spectroscopy changes are well reported in cirrhotic patients, whereas they are inadequately reported in EHPVO. The aim of this study was to investigate age-related changes in brain MR imaging and metabolite profile in EHPVO with and without MHE and to explore any correlation of imaging and 1H-MR spectroscopy parameters with blood ammonia. MATERIALS AND METHODS: Sixty-three patients with EHPVO (children, 7-12 years [n = 22], adolescents, 13-18 years [n = 15] and adults, 19-41 years [n = 26]) and 47 healthy age/sex-matched volunteers were studied. Neuropsychological tests, MR imaging, 1H-MR spectroscopy, and blood ammonia estimation were performed in all subjects. RESULTS: Of 63 EHPVO patients, 25 (40%) who had MHE showed significantly increased MD, Glx, and blood ammonia in all 3 age groups; however, myo-inositol was significantly lower only in adults when compared with controls. MD positively correlated with blood ammonia and Glx in all age groups. Brain choline levels were normal in all patients with different age groups. CONCLUSIONS: Increases in brain MD, Glx, and blood ammonia were associated with MHE in all age groups. Normal brain choline in EHPVO signifies healthy liver and may serve as a diagnostic marker for its differentiation from cirrhosis-induced encephalopathy. Significant decrease of myo-inositol in adults is probably due to cellular osmoregulation secondary to long-standing hyperammonemia.

AB - BACKGROUND AND PURPOSE: MR imaging and 1H-MR spectroscopy changes are well reported in cirrhotic patients, whereas they are inadequately reported in EHPVO. The aim of this study was to investigate age-related changes in brain MR imaging and metabolite profile in EHPVO with and without MHE and to explore any correlation of imaging and 1H-MR spectroscopy parameters with blood ammonia. MATERIALS AND METHODS: Sixty-three patients with EHPVO (children, 7-12 years [n = 22], adolescents, 13-18 years [n = 15] and adults, 19-41 years [n = 26]) and 47 healthy age/sex-matched volunteers were studied. Neuropsychological tests, MR imaging, 1H-MR spectroscopy, and blood ammonia estimation were performed in all subjects. RESULTS: Of 63 EHPVO patients, 25 (40%) who had MHE showed significantly increased MD, Glx, and blood ammonia in all 3 age groups; however, myo-inositol was significantly lower only in adults when compared with controls. MD positively correlated with blood ammonia and Glx in all age groups. Brain choline levels were normal in all patients with different age groups. CONCLUSIONS: Increases in brain MD, Glx, and blood ammonia were associated with MHE in all age groups. Normal brain choline in EHPVO signifies healthy liver and may serve as a diagnostic marker for its differentiation from cirrhosis-induced encephalopathy. Significant decrease of myo-inositol in adults is probably due to cellular osmoregulation secondary to long-standing hyperammonemia.

UR - http://www.scopus.com/inward/record.url?scp=77955618981&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955618981&partnerID=8YFLogxK

U2 - 10.3174/ajnr.A2045

DO - 10.3174/ajnr.A2045

M3 - Article

C2 - 20223885

AN - SCOPUS:77955618981

VL - 31

SP - 1337

EP - 1342

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 7

ER -