Magnetic resonance imaging (MRI) and 1H magnetic resonance spectroscopy (1H-MRS) have been used in clinics for diagnosis of chronic liver diseases. weeks of post-transplantation; the MR imaging of Mn in the globus pallidus completely disappeared SEDC 5 buy 151319-34-5 weeks after the surgery. Taken with buy 151319-34-5 each other, this clinical study, which combined MRI/MRS analysis, autopsy exam and liver transplant, clearly demonstrates that liver injury-induced brain Mn accumulation can reversibly alter the homeostasis of brain metabolites Cho, mI and Glx. Our data further suggest that liver transplantation can restore normal brain Mn levels. reported a positive correlation between PI values and blood ammonia concentrations among 22 patients with acquired (non-Wilsonian) hepatocerebral degeneration (AHD) (14). The study, however, does not reveal whether and how the disease progression may affect the PI values among the patients. Recently, the hydrogen proton magnetic resonance (1H-MRS) has been used to study the status of brain metabolites among CHE patients. Krieger and his colleagues reported a decline in choline compounds (Cho) and myo-inositol (mI) buy 151319-34-5 and an increase in glutamine/glutamic compounds (Glx) among CHE patients (15). Other studies have come to the similar conclusion (7, 16, 17). However, the correlation between the altered brain metabolites and the degree of hepatic damage has never been established. Even less is known about brain MRI and MRS outcomes among patients pre- and buy 151319-34-5 post- their receiving liver transplants. The current study was designed to investigate whether MRI and 1H-MRI could be simultaneously used to reflect Mn accumulation in brain and changes in brain metabolites among patients with varying degrees of liver damage from minor chronic hepatitis (CH) to moderate cirrhosis and to severe CHE. In addition to MRI and MRS quantifications, the correlations between MRI/MRS outcomes and blood levels of Mn and ammonia were investigated. Moreover, MRI and MRS studies were performed among patients who have received a liver transplant in order to compare MRI and MRS outcomes in the same individuals before and after liver transplantation. Subjects and Methods Patients with Liver Diseases and Control Subjects A total of 50 patients with chronic liver diseases (44 males and 6 females) were recruited from a pool of patients admitted to the buy 151319-34-5 First Affiliated Hospital of Guangxi Medical University (GMU). The control group consisted of 20 healthy volunteers (13 males and 7 females). The imply ages were 41 years (range: 15C66) and 39 years (range: 21C65), respectively, for the patients and regulates. The patients with chronic liver diseases were further divided into three groups. (i) The chronic hepatitis (CH) group experienced a total of 17 patients who suffered from liver disease for more than 6 months, were positive for hepatitis B computer virus surface antigen, exhibited hepatic dysfunction by biochemical examinations, and showed clear clinical hepatitis symptoms. Of the patients in the CH group, 5 experienced prolonged chronic hepatitis, and 12 experienced chronic active hepatitis. (ii) The patients in the cirrhosis group (= 20) experienced clinically diagnosed cirrhosis, but without central nervous system (CNS) symptoms, and experienced no history of hepatic coma in the past. Among the cirrhosis patients, 2 were diagnosed as alcoholic cirrhosis and 18 as post-hepatitic cirrhosis. (iii) The chronic hepatic encephalopathy (CHE) group was comprised of 13 patients with clinically diagnosed severe chronic hepatitis or cirrhosis, accompanied by CNS symptoms. While all 13 patients experienced acute episodes of hepatic encephalopathy, 10 of these patients were in the prodromal period, and 3 suffered from the coma. Table 1 summarizes the demographic data of the study participants. Table 1 Summary of Demographic Data Among Control and Patients with Liver Diseasesa Prior to clinical examinations and MRI/MRS study, a written knowledgeable consent form was obtained from all study participants. Clinical Examination and Liver Transplant The diagnoses were carried out by clinicians according to the clinical symptoms, physical signs, laboratory examinations, and results of computed tomography (CT) and ultrasound scans. In severe liver disease conditions, little pieces.