Adding another spectral dimension to 1H magnetic resonance spectroscopy of hepatic encephalopathy

Nader Binesh, Amir Huda, Mary Bugbee, Rakesh Gupta, Natalie Rasgon, Anand Kumar, Michael Green, Steven Han, M. Albert Thomas

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Purpose: To evaluate a localized two-dimensional correlated magnetic resonance spectroscopic (L-COSY) technique in patients with hepatic encephalopathy (HE) and healthy subjects, and to correlate the cerebral metabolite changes with neuropsychological (NP) test scores. Materials and Methods: Eighteen minimal hepatic encephalopathy (MHE) patients and 21 healthy controls have been investigated. A GE 1.5-T magnetic resonance (MR) scanner was used in combination with a body MR coil for transmission and a 3-inch surface coil for reception. A 27-mL voxel was localized by three slice-selective radio frequency (RF) pulses (90°-180°-90°) in the anterior cingulate region. The total duration of each two-dimensional L-COSY spectrum was approximately 25 minutes. The NP battery included a total of 15 tests, which were grouped into six domains. Results: MR spectroscopic results showed a statistically significant decrease in myo-inositol (ml) and choline (Ch) and an increase in glutamate/glutamine (Glx) in patients when compared to healthy controls. There was also an increase in taurine (Tau) in patients. The NP results indicated a significant correlation between motor function assessed by NP tests and ml ratios recorded using two-dimensional L-COSY. Conclusion: The study demonstrated the feasibility of evaluating the two-dimensional L-COSY sequence in a clinical environment. The results showed additional cerebral metabolites that can be measured with the technique in comparison to one-dimensional study.

Original languageEnglish
Pages (from-to)398-405
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Issue number4
StatePublished - Apr 2005
Externally publishedYes


  • COSY
  • Cerebral metabolites
  • Hepatic encephalopathy
  • MR spectroscopy
  • Neuropsychology


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