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Neuroradiology

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01-11-2010 | Diagnostic Neuroradiology

Wilson’s disease: ³¹P and ¹H MR spectroscopy and clinical correlation

Authors: Sanjib Sinha, A. B. Taly, S. Ravishankar, L. K. Prashanth, M. K. Vasudev

Published in: Neuroradiology | Issue 11/2010

Abstract

Introduction

Proton (¹H) magnetic resonance spectroscopy (MRS) changes are noted in Wilson’s disease (WD). However, there are no studies regarding membrane phospholipid abnormality using ³¹P MRS in these patients. We aimed to analyze the striatal spectroscopic abnormalities using ³¹P and ¹H MRS in WD.

Methods

Forty patients of WD (treated, 29; untreated,11) and 30 controls underwent routine MR image sequences and in vivo 2-D ³¹P and ¹H MRS of basal ganglia using an image-selected technique on a 1.5-T MRI scanner. Statistical analysis was done using Student’s t test.

Results

The mean durations of illness and treatment were 6.2 ± 7.4 and 4.8 ± 5.9 years, respectively. MRI images were abnormal in all the patients. ¹H MRS revealed statistically significant reduction of N-acetyl aspartate (NAA)/choline (Cho) and NAA/creatine ratios in striatum (¹H MRS) of treated patients compared to controls. The mean values of phosphomonoesters (PME) (p < 0.0001), phosphodiesters (PDE) (p < 0.0001), and total phosphorus (TPh) (p < 0.0001) were elevated in patients compared to controls. Statistically significant elevated levels of ratio of PME/PDE (p = 0.05) observed in the striatum were noted in treated patients as compared to controls in the ³¹P MRS study. The duration of illness correlated well with increased PME/PDE [p < 0.001], PME/TPh [p < 0.05], and PDE/TPh [p < 0.05] and decreased NAA/Cho [p < 0.05] ratios. There was correlation of MRI score and reduced NAA/Cho ratio with disease severity. The PME/PDE ratio (right) was elevated in the treated group [p < 0.001] compared to untreated group.

Conclusions

There is reduced breakdown and/or increased synthesis of membrane phospholipids and increased neuronal damage in basal ganglia in patients with WD.

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Title: Wilson’s disease: 31P and 1H MR spectroscopy and clinical correlation
Authors: Sanjib Sinha
A. B. Taly
S. Ravishankar
L. K. Prashanth
M. K. Vasudev
Publication date: 01-11-2010
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 11/2010
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-010-0661-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Wilson’s disease: ³¹P and ¹H MR spectroscopy and clinical correlation

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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