Proton MR spectroscopy of the brain in patients treated with TIPS.

ABSTRACT

PURPOSE: To evaluate the utility of proton MR spectroscopy (MRS) for the early detection of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunting (TIPS). MATERIAL AND METHODS: Six patients, who underwent TIPS for treatment of portal hypertension, were examined by MRS I week before and 1 week after TIPS. They were simultaneously clinically examined for number connection test, blood NH3 level, liver function test and the Fischer ratio. RESULT: Three of 6 patients showed overt HE 1 to 5 weeks after TIPS and the other 3 patients did not show overt HE. The overt HE group showed the larger ratio of the amounts of glutamine and glutamate/myo-inositol (Glx/MI) than that of non-overt HE group (p<0.05). CONCLUSION: The Glx/MI ratio estimated by MRS was useful for early detection of HE after TIPS.