Proton magnetic resonance spectroscopy in portal-systemic encephalopathy

Localized proton magnetic resonance spectroscopy (MRS) with short echo time s provides unique information of human cerebral metabolism. Studies on pati ents with portal-systemic encephalopathy (PSE) have been performed to clari fy the pathogenesis of this disease and to find a method which allows an ob jective diagnosis. Spectra of patients with PSE show typical abnormalities. Regional variations of these spectral changes are observed. The metabolic changes correlate with the grade of encephalopathy but the dependence on th e Child-Pugh score is controversial. No causal dependence between MRS findi ngs and abnormalities in magnetic resonance imaging is evident. Differences in magnetic resonance spectra in patients compared to controls vanish afte r liver transplantation, but increase after TIPS. The results of proton mag netic resonance spectroscopy are important for an understanding of the path ogenesis of PSE, but do not aid in the diagnosis of subclinical hepatic enc ephalopathy.