Santosh Kumar Yadav1, Amit Goel2,
Vivek A. Saraswat2, R KS Rathore3, M A. Thomas4,
A Yadav1, K N. Prasad5, C M. Pandey6, Rakesh
Kumar Gupta1
1Radiodiagnosis, Sanjay Gandhi Post
Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 2Gastroenterology,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar
Pradesh, India; 3Mathematics and Statistics, Indian Institute of
technology Kanpur, Kanpur, Uttar Pradesh, India; 4Radiological
Sciences, UCLA School of Medicine, Los Angeles, CA, Los Angeles, CA, United
States; 5Microbiology, Sanjay Gandhi Post Graduate Institute of
Medical Sciences, Lucknow, Uttar Pradesh, India; 6Biostatistics,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar
Pradesh, India
Thirty-three
cirrhotic MHE and 14 EHPVO MHE with 23 age/sex matched control were included
in final analysis. Liver function test, NPT, CFF, blood ammonia,
proinflammatory molecules, MR imaging and 1H MR spectroscopy were recorded in
all patients. MHE was significantly higher in cirrhosis than EHPVO.
Significantly increased blood ammonia, proinflammatory molecules, Glx/Cr and
MD with decreased mIns/Cr was observed in both form of MHE as compared to
controls, however Cho/Cr significantly decreased only in cirrhotic MHE as
compared to EHPVO MHE and controls. Increased blood ammonia, proinflammatory
molecules, Glx/Cr and MD with decreased mIns/Cr is common in both form of MHE
and involved the pathogenesis of MHE, however Cho/Cr depletion was observed
only in cirrhotic MHE, confirms that Cho/Cr depletion is related to liver
dysfunction and is unrelated to MHE. Our study confirms that there are
differences in biochemical, proinflammatory molecules and MR profile in MHE
of cirrhosis and EHPVO.
Keywords