Abstract #0607

Insights from the downfield proton MR spectrum: establishing peak assignments and novel pathophysiologic findings in hepatic encephalopathy

Jessie Mosso^1,2,3, Roland Kreis^4,5, Bernard Lanz^1,2, and Cristina Cudalbu^1,2

¹CIBM Center for Biomedical Imaging, Lausanne, Switzerland, ²Animal Imaging and Technology, EPFL, Lausanne, Switzerland, ³Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States, ⁴Magnetic Resonance Methodology, Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland, ⁵Translational Imaging Center, Sitem-insel, Bern, Switzerland

Synopsis

Keywords: Spectroscopy, Spectroscopy, Hepatic encephalopathy, downfield MRS, glutamine, rat brain, glucose

Motivation: A comprehensive picture of cerebral energy metabolism alterations in hepatic encephalopathy (HE) is still missing and ¹H-MRS studies were so far limited to the upfield region.

Goal(s): Use metabolite-cycling (MC) to investigate ¹H-MRS downfield resonances, in particular glutamine and energy metabolites, in a rat model of HE.

Approach: Acquisitions with MC in the short-TE full-intensity SPECIAL sequence at 14.1T in striatum of 10 HE and 10 control rats.

Results: Glucose (5.23ppm) was reliably measured and severely depleted in HE, while ATP (isolated 6.1ppm resonance) remained unchanged. The strong correlation between glutamine upfield and downfield resonances confirms the identification of downfield glutamine peaks (6.8/7.5ppm).

Impact: Metabolite-cycled ¹H-MRS used here in an animal model of hepatic encephalopathy enabled unique access to energy metabolites with downfield resonances (glucose, ATP) and will shed new light on energy metabolism alterations at stake in this disease.

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