Clinical study of pathogenic mechanism of minimal hepatic encephalopathy using ultra-high magnetic field 7 Tesla MRI
| Project/Area Number |
15K19346
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Gastroenterology
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| Research Institution | Iwate Medical University |
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Principal Investigator |
SAWARA KEI 岩手医科大学, 医学部, 非常勤医師 (40405816)
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2015: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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| Keywords | ミニマル肝性脳症 / カルニチン / グルタミン / ミオイノシトール / MRI / MRS / DKI / mean kurtosis (MK) / アンモニア / NPテスト |
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| Outline of Final Research Achievements |
Compared with liver cirrhosis patients without minimal hepatic encephalopathy (non MHE), liver cirrhosis patients with minimal hepatic encephalopathy (MHE) showed marked increase in glutamine in the brain and decrease in myoinositol in the brain. We examined the predictors of onset of MHE, showed that elevated blood ammonia levels, the ratio of total serum carnitine to serum acylcarnitine (Ac-CA / T-CA ratio), elevated levels of creatine, and decreased levels of eGFR are predictors. We measured diffusion kurtosis imaging (DKI) in the brain and found that mean kurtosis (MK) decreased in putamen in the MHE group compared to the non MHE group. From these results, we considered that the elucidation of pathogenic mechanism of MHE has been advanced one step further.
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| Academic Significance and Societal Importance of the Research Achievements |
肝硬変患者において肝性脳症は重篤な合併症であり、その前段階であるミニマル肝性脳症は記憶力や集中力の低下を招き交通違反や交通事故にも繋がる可能性があり、今後大きな社会的問題となることが示唆されている。従いミニマル肝性脳症の病態を解明し、早期に診断することは非常に重要である。本研究では、ミニマル肝性脳症発症予測因子を検討し、高磁場MRIを用いて脳内の微細な変化を捉え、新たな知見が得られたことによりミニマル肝性脳症の病態を解明、早期診断に寄与したと考えられ、学術的、社会的に大きな意義があったと考えられる。
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Report
(5 results)
Research Products
(9 results)
