Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy

Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy

Background: Hepatic encephalopathy (HE) is a complication of transjugular intrahepatic portosystemic shunt (TIPS). Aims: Extend the knowledge about the early detection of multiple brain metabolic abnormalities following TIPS; these abnormalities can be detected and managed prior to the clinical mani...

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Main Authors: Laura Greco, Fabrizio Chegai, Maria Claudia Pensabene, Laura De Corato, Enrico Pampana, Ilaria Lenci, Francesco Garaci, Roberto Floris, Milena Melis
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:European Journal of Radiology Open
Online Access:http://www.sciencedirect.com/science/article/pii/S2352047719300437
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spelling doaj-8ddfc86d98084ddda5353d4a466d308b2020-11-25T02:15:08ZengElsevierEuropean Journal of Radiology Open2352-04772019-01-016350357Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopyLaura Greco0Fabrizio Chegai1Maria Claudia Pensabene2Laura De Corato3Enrico Pampana4Ilaria Lenci5Francesco Garaci6Roberto Floris7Milena Melis8Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyCorresponding author.; Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyDepartment of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome, “Tor Vergata”, Viale Oxford 81, 00133, Rome, ItalyBackground: Hepatic encephalopathy (HE) is a complication of transjugular intrahepatic portosystemic shunt (TIPS). Aims: Extend the knowledge about the early detection of multiple brain metabolic abnormalities following TIPS; these abnormalities can be detected and managed prior to the clinical manifestation of HE with use of Multiparametric Magnetic Resonance with Spectroscopy. Methods: 12 cirrhotic Patients underwent TIPS; each Patient underwent a 3 T MRI evaluation before and after TIPS. The spectroscopic images were processed measuring the values of the metabolites N-acetylaspartate (NAA) - Glutamine / Glutamate (Glx) - Colina (Cho) - Myinositol (mI) at the level of the nuclei of the base. Results: Spectroscopic examination performed before the TIPS procedure showed low values of Cho and Mi, instead following the procedure: an increase in the Glx value, a mean reduction in the values of Cho and mI, a statistically significant reduction in the Cho / Creatine ratio, in the mI / Creatine ratio and an increase of the Glx / Creatine ratio. Conclusions: Our study demonstrated the efficacy of spectroscopy in Patient subjected to TIPS. MR 3 T with spectroscopy can become a valid tool for monitor the dynamics of changes in brain metabolism after TIPS and to provide an early diagnosis of HE allowing an early treatment. Keywords: Hepatic encephalopathy (HE), Transjugular intrahepatic portosystemic shunt (TIPS), Multiparametric magnetic resonance, Spectroscopyhttp://www.sciencedirect.com/science/article/pii/S2352047719300437
collection DOAJ
language English
format Article
sources DOAJ
author Laura Greco
Fabrizio Chegai
Maria Claudia Pensabene
Laura De Corato
Enrico Pampana
Ilaria Lenci
Francesco Garaci
Roberto Floris
Milena Melis
spellingShingle Laura Greco
Fabrizio Chegai
Maria Claudia Pensabene
Laura De Corato
Enrico Pampana
Ilaria Lenci
Francesco Garaci
Roberto Floris
Milena Melis
Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
European Journal of Radiology Open
author_facet Laura Greco
Fabrizio Chegai
Maria Claudia Pensabene
Laura De Corato
Enrico Pampana
Ilaria Lenci
Francesco Garaci
Roberto Floris
Milena Melis
author_sort Laura Greco
title Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
title_short Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
title_full Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
title_fullStr Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
title_full_unstemmed Early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
title_sort early detection of hepatic encephalopathy after transjugular intrahepatic portsystemic shunt using multiparametric magnetic resonance with spectroscopy
publisher Elsevier
series European Journal of Radiology Open
issn 2352-0477
publishDate 2019-01-01
description Background: Hepatic encephalopathy (HE) is a complication of transjugular intrahepatic portosystemic shunt (TIPS). Aims: Extend the knowledge about the early detection of multiple brain metabolic abnormalities following TIPS; these abnormalities can be detected and managed prior to the clinical manifestation of HE with use of Multiparametric Magnetic Resonance with Spectroscopy. Methods: 12 cirrhotic Patients underwent TIPS; each Patient underwent a 3 T MRI evaluation before and after TIPS. The spectroscopic images were processed measuring the values of the metabolites N-acetylaspartate (NAA) - Glutamine / Glutamate (Glx) - Colina (Cho) - Myinositol (mI) at the level of the nuclei of the base. Results: Spectroscopic examination performed before the TIPS procedure showed low values of Cho and Mi, instead following the procedure: an increase in the Glx value, a mean reduction in the values of Cho and mI, a statistically significant reduction in the Cho / Creatine ratio, in the mI / Creatine ratio and an increase of the Glx / Creatine ratio. Conclusions: Our study demonstrated the efficacy of spectroscopy in Patient subjected to TIPS. MR 3 T with spectroscopy can become a valid tool for monitor the dynamics of changes in brain metabolism after TIPS and to provide an early diagnosis of HE allowing an early treatment. Keywords: Hepatic encephalopathy (HE), Transjugular intrahepatic portosystemic shunt (TIPS), Multiparametric magnetic resonance, Spectroscopy
url http://www.sciencedirect.com/science/article/pii/S2352047719300437
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