Journal of Hepatology
Volume 52, Issue 3 , Pages 348-354 , March 2010

Encephalopathy assessment in children with extra-hepatic portal vein obstruction with MR, psychometry and critical flicker frequency

  • Santosh K. Yadav

      Affiliations

    • Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, UP, India
    • ,
  • Anshu Srivastava

      Affiliations

    • Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Arti Srivastava

      Affiliations

    • Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, UP, India
    • ,
  • Michael A. Thomas

      Affiliations

    • Department of Radiological Sciences, David Geffen School of Medicine at UCLA, CA, USA
    • ,
  • Jaya Agarwal

      Affiliations

    • Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Chandra M. Pandey

      Affiliations

    • Department of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Richa Lal

      Affiliations

    • Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Surender K. Yachha

      Affiliations

    • Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Vivek A. Saraswat

      Affiliations

    • Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    • ,
  • Rakesh K. Gupta

      Affiliations

    • Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, UP, India
    • Corresponding Author InformationCorresponding author. Tel.: +91 522 2668700x2599 (O); fax: +91 522 2668017.

Received 25 June 2009 ,Revised 30 August 2009 ,Accepted 17 September 2009.

References 

  1. Yachha SK, Khanduri A, Sharma BC, Kumar M. Gastrointestinal bleeding in children. J Gastroenterol Hepatol. 1996;11:903–907
  2. Sharma P, Sharma BC, Puri V, Sarin SK. Minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction. Am J Gastroenterol. 2008;103:1406–1412
  3. Ferenci P, Lockwood AH, Mullen KD, Tarter RE, Weissenborn K, Blei AT, et al. Hepatic encephalopathy-definition, nomenclature, diagnosis and quantification: final report of the working party at the 11th World Congress of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721
  4. Norenberg MD, Jayakumar AR, Rama Rao KV. Oxidative stress in the pathogenesis of hepatic encephalopathy. Metab Brain Dis. 2004;19:313–329
  5. Kale RA, Gupta RK, Saraswat VA, Hasan KM, Trivedi R, Mishra AM, et al. Demonstration of interstitial cerebral edema with diffusion tensor MR imaging in type C hepatic encephalopathy. Hepatology. 2006;43:698–706
  6. Haussinger D, Kircheis G, Fischer R, Schliess F, Vom DS. Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema?. J Hepatol. 2000;32:1035–1038
  7. Oritz M, Cordoba J, Alonso J, Rovira A, Quiroga S, Jacas C, et al. Oral glutamine challenge and magnetic resonance spectroscopy in three patients with congenital portosystemic shunts. J Hepatol. 2004;40:552–557
  8. Dhiman RK, Chawla YK. Minimal hepatic encephalopathy: time to recognize and treat. Trop Gastroenterol. 2008;29:6–12
  9. Minguez B, Garcia-Pagan JC, Bosch J, Turnes J, Alonso J, Rovira A, et al. Noncirrhotic portal vein thrombosis exhibits neuropsychological and MR changes consistent with minimal hepatic encephalopathy. Hepatology. 2006;43:707–714
  10. Miese F, Kircheis G, Wittsack HJ, Wenserski F, Hemker J, Modder U, et al. 1H MR spectroscopy, magnetization transfer, and diffusion-weighted imaging in alcoholic and nonalcoholic patients with cirrhosis with hepatic encephalopathy. AJNR Am J Neuroradiol. 2006;27:1019–1026
  11. Kreis R, Ross BD, Farrow NA, Ackerman Z. Metabolic disorders of the brain in chronic hepatic encephalopathy detected with 1H MR spectroscopy. Radiology. 1992;182:19–27
  12. Rose C, Butterworth RF, Zayed J, Normandin L, Todd K, Michalak A, et al. Manganese deposition in basal ganglia structures results from both portal-systemic shunting and liver dysfunction. Gastroenterology. 1999;117:640–644
  13. Kreis R, Farrow N, Ross BD. Diagnosis of hepatic encephalopathy by proton magnetic resonance spectroscopy. Lancet. 1990;336:635–636
  14. Sarin SK, Sollano JD, Chawla YK, Amarapurkar D, Hamid S, Hashizume M, et al. Consensus on extra-hepatic portal vein obstruction. Liver Int. 2006;26:512–519
  15. Khire U, Bleichrodt N, Hoksbergen Rene AC, Bharat S, Athavale U, Kher R. Indian child intelligence test (ICIT), technical manual, adaptation of revised Amsterdamse Kinder Intelligentie test. 1st ed.. India: Jnana Prabodhini’s Samshodhan Sanstha; 1992;
  16. Das A, Dhiman RK, Saraswat VA, Verma M, Naik SR. Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis. J Gastroenterol Hepatol. 2001;16:531–535
  17. Provencher SW. Automatic quantitation of localized in vivo 1H spectra with LC Model. NMR Biomed. 2001;14:260–264
  18. Verma A, Saraswat VA, Radha Krishna Y, Nath K, Thomas MA, Gupta RK. In-vivo 1H magnetic resonance spectroscopy-derived metabolites variations between acute-on-chronic liver failure and acute liver failure. Liver Int. 2008;28:1095–1103
  19. Kircheis G, Wettstein M, Timmermann L, Schnitzler A, Haussinger D. Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology. 2002;35:357–366
  20. Lockwood AH. Positron emission tomography in the study of hepatic encephalopathy. Metab Brain Dis. 2002;17:431–435
  21. Laubenberger J, Haussinger D, Bayer S, Gufler H, Hinning J, Langer M. Proton magnetic resonance spectroscopy of the brain in symptomatic and asymptomatic patients with liver cirrhosis. Gstroenterology. 1997;112:1610–1616
  22. Brand A, Richter-Landsberg C, Leibfritz D. Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. Dev Neurosci. 1993;15:289–298
  23. Balata S, Olde Damink SW, Ferguson K, Marshall I, Hayes PC, Deutz NE, et al. Induced hyperammonemia alters neuropsychology, brain MR spectroscopy and magnetization transfer in cirrhosis. Hepatology. 2003;37:931–939
  24. Kreis R, Hofmann L, Kuhlmann B, Boesch C, Bossi E, Huppi PS. Brain metabolite composition during early human brain development as measured by quantitative in-vivo 1H magnetic resonance spectroscopy. Magn Reson Med. 2002;48:949–958
  25. Inoue E, Hori S, Narumi Y, Fujita M, Kuriyama K, Kadota T, et al. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images. Radiology. 1991;179:551–555

PII: S0168-8278(09)00813-7

doi: 10.1016/j.jhep.2009.12.012

Journal of Hepatology
Volume 52, Issue 3 , Pages 348-354 , March 2010

Article Tools

* Image Usage & Resolution