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CASE REPORT: Usefulness of Magnetic Resonance Spectroscopy for Diagnosis of Hepatic Encephalopathy in a Patient with Relapsing Confusional Syndrome

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REFERENCES

  1. Conn HO: The hepatic encephalopathies. In HO Conn, J Bircher, (eds). Hepatic Encephalopathy. Syndromes and Therapies. Bloomington, Illinois, Medi-Ed Press, 1994, pp1–12

    Google Scholar 

  2. Kuramitsu T, Komatsu M, Matsudaira N, Naganuma T, Nizawa M, Zeniya A, Yoshida T: Portal-systemic encephalopathy from a spontaneous shunt diagnosed by three-dimensional computed tomography and treated effectively by percutaneous vascular embolization. Liver 18:208–212, 1998

    Google Scholar 

  3. Jalan R, Olde Damink SWM, Hayes PC, Wardlaw JM: Diagnosis of hepatic encephalopathy: will in vivo proton 1H-MRS play a role? Hepatology 29:1605–1607, 1999

    Google Scholar 

  4. Schenker S, Butterworth RF: 1H-MR spectroscopy in portalsystemic encephalopathy: are we there yet? Gastroenterology 112:1758–1761, 1997

    Google Scholar 

  5. Ross BD, Danielsen ER, Blüml S: Proton magnetic resonance spectroscopy: The new gold standard for diagnosis of clinical and subclinical hepatic encephalopathy? Dig Dis 14(suppl1): 30–39, 1996

    Google Scholar 

  6. Meyerhoff DJ, Bloomer C, Cardenas V, Norman D, Weiner MW, Fein G: Elevated subcortical choline metabolites in cognitively and clinically asymptomatic HIV+ patients. Neurology 52:995–1003, 1999

    Google Scholar 

  7. Adamson AJ, Rand SD, Prost RW, Kim TA, Schultz C, Haughton VM: Focal brain lesions: Effects of single-voxel proton 1H-MR spectroscopic findings on treatment decisions. Radiology 209:73–78, 1998

    Google Scholar 

  8. Kreis R, Ross BD, Farrow NA, Ackerman Z: Metabolic disorders of the brain in chronic hepatic encephalopathy detected with 1H-MR spectroscopy. Radiology 182:19–27, 1992

    Google Scholar 

  9. Butterworth RF: The neurobiology of hepatic encephalopathy. Seminars in Liver Dis 16:235–244, 1996

    Google Scholar 

  10. Butterworth RF, Giguere JF, Michaud J, Lavoie J, Layrargues GP: Ammonia: Key factor in the pathogenesis of hepatic encephalopathy. Neurochem Pathol 6:1–12, 1987

    Google Scholar 

  11. Cordoba J, Gottstein J, Blei AT: Glutamine, myo-inositol and other organic osmolytes after portacaval anastomosis in the rat, Implications for ammonia-induced brain edema. Hepatology 24:919–923, 1996

    Google Scholar 

  12. Häussinger D, Kircheis G, Fischer R, Schliess F, vom Dahl S: Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema? J Hepatol 32:1035–1038, 2000

    Google Scholar 

  13. Hourani BT, Hamlin EM, Reynolds TB: Cerebrospinal fluid glutamine as a measure of hepatic encephalopathy. Arch Intern Med 127:1033–1036, 1971

    Google Scholar 

  14. Haseler LJ, Sibbitt WL, Motjahedzadeh HN, Reddy S, Agarwal VP, McCarthy DM: Proton 1H-MR spectroscopic measurement of neurometabolites in hepatic encephalopathy during oral lactulose therapy. Am J Neuroradiology 19:1681–1686, 1998

    Google Scholar 

  15. Kulisewsky J, Pujol J, Balanzo J, Junque C, Deus J, Capdevila A, Villanueva C: Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patient: clinical correlations. Hepatology 16:1382–1388, 1992

    Google Scholar 

  16. Spahr L, Butterworth RF, Fontaine S, Bui L, Therrien G, Milette PC, Lebrum LH, Zayed J, Leblanc A, Pomier-Layrargues G: Increased blood manganese in cirrhotic patients: relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms. Hepatology 24:1116-1120, 1996

    Google Scholar 

  17. Wondwosen A, Milan JC, Mezey E: Sampling variability on percutaneous liver biopsy. Arch Intern Med 139:667–669, 1979

    Google Scholar 

  18. Trejo R, Alvarez W, Garcia-Pagan JC, Feu F, Escorsell A, Bruguera M, Bosch J, Rodes J: Aplicabilidad y rentabilidad diagnóstica de la biopsia hepática transyugular. Med Clin (Barcelona) 107:521–523, 1996

    Google Scholar 

  19. Uflacker R, Silva A, d'Albuquerque LA, Piske RL, Mourao GS: Chronic portosystemic encephalopathy: Embolization of portosystemic shunts. Radiology 165:721–725, 1987

    Google Scholar 

  20. Nolte W, Wiltfang J, Schindler CG, Unterberg K, Finkenstaedt M, Niedmann PD, Hartman H, Ramadori G: Bright basal ganglia in T1-weighted magnetic resonance images are frequent in patients with portal vein thrombosis without liver cirrhosis and not suggestive of hepatic encephalopathy. J Hepatol 29:443–449, 1998

    Google Scholar 

  21. Matsumoto S, Mori H, Yoshioka K, Kiyosue H, Komatsu E: Effects of portal-systemic shunt embolization on the basal ganglia: 1H-MRI. Neuroradiology 39:326–328, 1997

    Google Scholar 

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Cordoba, J., Hinojosa, C., Sampedro, F. et al. CASE REPORT: Usefulness of Magnetic Resonance Spectroscopy for Diagnosis of Hepatic Encephalopathy in a Patient with Relapsing Confusional Syndrome. Dig Dis Sci 46, 2451–2455 (2001). https://doi.org/10.1023/A:1012323819757

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