Brain Magnetic Resonance in Hepatic Encephalopathy

被引:38
作者
Alonso, Juli [1 ,2 ]
Cordoba, Juan [2 ,3 ]
Rovira, Alex [1 ]
机构
[1] Hosp Valle De Hebron, VHIR, Unitat Ressonancia Magnet IDI, Dept Radiol, Barcelona 08035, Spain
[2] CIBEREHD, Barcelona, Spain
[3] Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
关键词
WHITE-MATTER LESIONS; CHRONIC LIVER-DISEASE; PROTON MR SPECTROSCOPY; SERUM PROINFLAMMATORY CYTOKINES; APPARENT DIFFUSION-COEFFICIENT; HYPERINTENSE GLOBUS-PALLIDUS; PORTAL-VEIN OBSTRUCTION; BASAL GANGLIA; CEREBRAL EDEMA; SIGNAL INTENSITY;
D O I
10.1053/j.sult.2013.09.008
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The term hepatic encephalopathy (HE) covers a wide spectrum of neuropsychiatric abnormalities caused by portal-systemic shunting. The diagnosis requires demonstration of liver dysfunction or portal-systemic shunts and exclusion of other neurologic disorders. Most patients with this condition have liver dysfunction caused by cirrhosis, but it also occurs in patients with acute liver failure and less commonly, in patients with portal-systemic shunts that are not associated with hepatocellular disease. Various magnetic resonance (MR) techniques have improved our knowledge about the pathophysiology of HE. Proton MR spectroscopy and T1-weighted imaging can detect and quantify accumulations of brain products that are normally metabolized or eliminated such as glutamine and manganese. Other MR techniques such as T2-weighted and diffusion-weighted imaging can identify white matter abnormalities resulting from disturbances in cell volume homeostasis secondary to brain hyperammonemia. Partial or complete recovery of these abnormalities has been observed with normalization of liver function or after successful liver transplantation. MR studies have undoubtedly improved our understanding of the mechanisms involved in the pathogenesis of HE, and some findings can be considered biomarkers for monitoring the effects of therapeutic measures focused on correcting this condition. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:136 / 152
页数:17
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