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2018 Fiscal Year Final Research Report

Clinical study of pathogenic mechanism of minimal hepatic encephalopathy using ultra-high magnetic field 7 Tesla MRI

Research Project

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Project/Area Number 15K19346
Research Category

Grant-in-Aid for Young Scientists (B)

Allocation TypeMulti-year Fund
Research Field Gastroenterology
Research InstitutionIwate Medical University

Principal Investigator

SAWARA KEI  岩手医科大学, 医学部, 非常勤医師 (40405816)

Project Period (FY) 2015-04-01 – 2019-03-31
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
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.

Free Research Field

肝臓病

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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Published: 2020-03-30  

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