{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:09:44Z","timestamp":1789142984340,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPGN rep."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic hepatic encephalopathy (CHE) has been reported both in patients with congenital porto\u2010systemic shunts (CPSS) and chronic liver disease. CHE is difficult to recognize in children as there is no clear definition and its manifestations are highly variable. CHE is associated with variations in brain volumes and metabolites that have already been demonstrated using 1.5\u20103T MRI systems. However, the in\u2010depth study of brain metabolism requires the high spectral resolution of high magnetic fields.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives and Methods<\/jats:title><jats:p>We analyzed the neurometabolic profile, brain volumes and T<jats:sub>1<\/jats:sub> relaxation times of a child with a CPSS using high field proton magnetic resonance spectroscopy (<jats:sup>1<\/jats:sup>H MRS, 7T) combined with MRI and compared it to an age\u2010matched control group. We also evaluated the impact of shunt closure on neurocognitive symptoms using adapted neuropsychological tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>7T MRS revealed a significant increase in glutamine compared to controls, a decrease in brain osmolytes, and a slight elevation in NAA concentrations. 7T MRI scans showed morphological abnormalities but no changes in the signal intensity of the globus pallidus. Neurocognitive testing revealed attention deficit disorder, language difficulties, and mild intellectual disability. Most of these areas improved after shunt closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this paediatric case of type B HE with normal fasting ammonia, neurometabolic profile was compatible with what has been previously shown in chronic liver disease, while also demonstrating an isolated glutamine peak. In addition, neurocognitive function partially improved after shunt closure, arguing strongly for shunt closure in both presymptomatic and symptomatic patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpr3.12035","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T07:10:34Z","timestamp":1703833834000},"page":"35-42","source":"Crossref","is-referenced-by-count":1,"title":["Neurometabolism and brain morphometry in an adolescent female with an extra\u2010hepatic congenital portosystemic shunt"],"prefix":"10.1002","volume":"5","author":[{"given":"Isaline","family":"Chabbey","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Swiss Pediatric Liver Center, Division of Pediatric Surgery University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Cudalbu","sequence":"additional","affiliation":[{"name":"CIBM Center for Biomedical Imaging Vaud Switzerland"},{"name":"Animal Imaging and Technology Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eug\u00e9nie","family":"Barras","sequence":"additional","affiliation":[{"name":"Diagnostic Department, Pediatric Radiology Unit, Radiology Division Geneva University Hospitals Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylviane","family":"Hanquinet","sequence":"additional","affiliation":[{"name":"Diagnostic Department, Pediatric Radiology Unit, Radiology Division Geneva University Hospitals Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Mar\u00e9chal","sequence":"additional","affiliation":[{"name":"Advanced Clinical Imaging Technology Siemens Healthineers International AG Lausanne Switzerland"},{"name":"Department of Radiology, Lausanne University Hospital (CHUV) University of Lausanne Vaud Switzerland"},{"name":"LTSS, Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne (EPFL) Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Laure","family":"Rougemont","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology, Swiss Pediatric Liver Center Geneva University Hospitals Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Wacker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Pediatric Cardiology Unit University of Geneva, Geneva, Switzerland Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Zangas\u2010Gheri","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit Geneva University Hospitals Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie A.","family":"McLin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Swiss Pediatric Liver Center, Pediatric Gastroenterology, Hepatology and Nutrition Unit University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ab.2022.114576"},{"key":"e_1_2_7_3_1","unstructured":"International registry of Congenital Porto\u2010Sysemic Shunts. 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