Current and future applications of magnetic resonance imaging and spectroscopy of the brain in hepatic encephalopathy

Figure 5 ¹H MR spectroscopy water-suppressed proton spectra of an 8 mL voxel located in the parietal region including predominantly normal appearing white matter (insert images show position of the voxel) in a healthy control subject (left) and in a cirrhotic patient (right), acquired using a STEAM pulse sequence [1600/20/30/256 (TR/TE/TM/acquisitions)]. The main resonances correspond to N-acetylaspartate (NAA, 2.0 ppm), glutamate/glutamine (Glx, 2.1-2.5 ppm), creatine/phosphocreatine (Cr, 3.02 ppm), choline-containing compounds (Cho, 3.2 ppm), and myo-Inositol (mIns, 3.55 ppm). Comparison of the spectra shows a decrease in Cho and mIns resonances with an increase in the glutamate/glutamine region in the cirrhotic patient. Reproduced with the permission of Springer Science and Business Media, from Cordoba et al 2002[28].