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Research ArticleBRAIN

Magnetization Transfer Ratio Values and Proton MR Spectroscopy of Normal-appearing Cerebral White Matter in Patients with Liver Cirrhosis

Alex Rovira, Elisenda Grivé, Salvador Pedraza, Antoni Rovira and Juli Alonso
American Journal of Neuroradiology June 2001, 22 (6) 1137-1142;
Alex Rovira
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Elisenda Grivé
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Salvador Pedraza
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Antoni Rovira
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Juli Alonso
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    fig 1.

    Transverse T1-weighted image (inversion recovery spin-echo; 1500/20; inversion time, 650 ms; number of acquisitions, one), obtained at the level of the basal ganglia in a patient with liver cirrhosis, shows bilateral increased signal in the globus pallidus. For calculating the globus pallidus index, mean signal intensity was calculated from a region of interest localized in both the putamen (□) and globus pallidus (○).fig 2. Transverse MTR map of a supraventricular level, obtained from two proton density gradient-echo sequences (714/12; flip angle, 20 degrees; number of acquisitions, one), the first with and the second without an off-resonance preparation pulse. MTR values were obtained from four different voxels (□) located in otherwise normal-appearing white matter, as defined on the T2-weighted sequence, within both parietal and frontal lobes.fig 3. Axial T2-weighted image (fast spin-echo; 3550/90; number of acquisitions, two), obtained at a supraventricular level, shows the voxel from which the 1H-MRS image was obtained in the normal appearing white matter in the parietal lobe

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    fig 4.

    Water-suppressed proton spectra of an 8-mL voxel located in the parietal region, recorded with a stimulated echo-based pulse sequence (1600/20; magnetization transfer, 30; number of acquisitions, 256). The main resonances correspond to N-acetylaspartate (2.0 ppm), glutamic/glutamine (2.1−2.5 ppm), creatine/phosphocreatine (3.02 ppm), choline-containing compounds (3.2 ppm), and myo-inositol (3.55 ppm). Comparison of the spectra shows a decrease in choline and myo-inositol resonances, with an increase in the glutamic/glutamine region in the cirrhotic patient.

    A, Healthy control volunteer.

    B, Cirrhotic patient.

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    TABLE 1:

    1H-MRS metabolite ratios from the parietal white matter, normalized globus pallidus intensity (GPI) and MTR of different brain regions for the control and cirrhotic groups

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    TABLE 2:

    1H-MRS metabolite ratios from the parietal white matter normalized globus pallidus intensity and MTR of different brain regions for cirrhotic patients classified by the existence of a minimal hepatic encephalopathy

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American Journal of Neuroradiology: 22 (6)
American Journal of Neuroradiology
Vol. 22, Issue 6
1 Jun 2001
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Cite this article
Alex Rovira, Elisenda Grivé, Salvador Pedraza, Antoni Rovira, Juli Alonso
Magnetization Transfer Ratio Values and Proton MR Spectroscopy of Normal-appearing Cerebral White Matter in Patients with Liver Cirrhosis
American Journal of Neuroradiology Jun 2001, 22 (6) 1137-1142;

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Magnetization Transfer Ratio Values and Proton MR Spectroscopy of Normal-appearing Cerebral White Matter in Patients with Liver Cirrhosis
Alex Rovira, Elisenda Grivé, Salvador Pedraza, Antoni Rovira, Juli Alonso
American Journal of Neuroradiology Jun 2001, 22 (6) 1137-1142;
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