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European Radiology
Published in: European Radiology 11/2008

Open Access 01-11-2008 | Magnetic Resonance

Quantitative multivoxel 1H MR spectroscopy of the brain in children with acute liver failure

Authors: Paul E. Sijens, Heyder Alkefaji, Roelineke J. Lunsing, Francjan J. van Spronsen, Linda C. Meiners, Matthijs Oudkerk, Henkjan J. Verkade

Published in: European Radiology | Issue 11/2008

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Abstract

Acute liver failure (ALF)-related encephalopathy was previously characterized by MR spectroscopy of single voxels containing both grey and white matter brain tissue. Quantitative multivoxel MRS was used here to compare grey and white matter brain tissue concentrations of glutamate/glutamine (Glx) and lactate in ALF and associate the results with other liver function parameters. Five pediatric patients with ALF-related encephalopathy and five controls, examined after successful liver transplantation, were examined by brain MRI/MRS. ALF patients had higher Glx and lactate concentrations in brain white matter than controls (Glx + 125%: P < 0.01; lactate + 33%, P < 0.05) and higher Glx in grey matter (Glx + 125%: P < 0.01). Within the group of ALF patients positive correlations were found between grey or white matter lactate concentration and serum ammonia (P < 0.05), and negative correlations between grey or white matter Glx and venous pH (P < 0.001). This is the first study presenting evidence of high Glx levels in both white and grey matter brain tissue in ALF-related encephalopathy. The elevations in CNS Glx and lactate concentrations appear to relate to hepatic detoxification (ammonia, venous pH), rather than to liver parenchymal integrity (aspartate aminotransferase, alanine aminotransferase) or biliary cholestasis (bilirubin, γ-glutamyl transpeptidase, alkaline phosphatase).
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Metadata
Title
Quantitative multivoxel 1H MR spectroscopy of the brain in children with acute liver failure
Authors
Paul E. Sijens
Heyder Alkefaji
Roelineke J. Lunsing
Francjan J. van Spronsen
Linda C. Meiners
Matthijs Oudkerk
Henkjan J. Verkade
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
European Radiology / Issue 11/2008
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-1049-z

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