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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hepatic encephalopathy MRI

Introduction

Overview

Overview

Brain MRI may be helpful in the diagnosis of hepatic encephalopathy. Findings on MRI suggestive of of hepatic encephalopathy include symmetric high signal within the insula, thalamus, posterior limbs of the internal capsule, and cingulate gyrus in mild cases and diffuse cortical edema and hyperintensity with typically spared perirolandic and occipital regions in sever cases.

MRI

MRI

  • Brain MRI may be helpful in the diagnosis of hepatic encephalopathy but findings are not specific for hepatic encephalopathy.
  • Findings on MRI suggestive of of hepatic encephalopathy include:[1][2][3][4]
    • Symmetric high signal within the insula, posterior limbs of the internal capsule, thalamus, and cingulate gyrus in mild cases.
    • Diffuse cortical edema and hyperintensity with typically spared perirolandic and occipital regions in sever cases.
    • Some patients may have microhemorrhages of white matter or cortex in SWI.
MRI showing brain edema in hepatic encephalopathy Source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340
MRI showing brain edema in hepatic encephalopathy Source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340
References

References

  1. ↑ McKinney AM, Lohman BD, Sarikaya B, Uhlmann E, Spanbauer J, Singewald T; et al. (2010). “Acute hepatic encephalopathy: diffusion-weighted and fluid-attenuated inversion recovery findings, and correlation with plasma ammonia level and clinical outcome”. AJNR Am J Neuroradiol. 31 (8): 1471–9. doi:10.3174/ajnr.A2112. PMID 20448015.
  2. ↑ U-King-Im JM, Yu E, Bartlett E, Soobrah R, Kucharczyk W (2011). “Acute hyperammonemic encephalopathy in adults: imaging findings”. AJNR Am J Neuroradiol. 32 (2): 413–8. doi:10.3174/ajnr.A2290. PMID 21087942.
  3. ↑ Hegde AN, Mohan S, Lath N, Lim CC (2011). “Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus”. Radiographics. 31 (1): 5–30. doi:10.1148/rg.311105041. PMID 21257930.
  4. ↑ Benson JC, Payabvash S, Thalken GL, Alonso J, Rykken J, Ott F; et al. (2016). “Delineation of microhemorrhage in acute hepatic encephalopathy using susceptibility-weighted imaging”. Eur J Radiol. 85 (3): 629–34. doi:10.1016/j.ejrad.2015.12.025. PMID 26860677.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ;Mohamadmostafa Jahansouz M.D.[2]