Hepatic encephalopathy MRI: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hepatic encephalopathy}} | {{Hepatic encephalopathy}} | ||
{{CMG}} {{AE}} | {{CMG}} {{AE}};{{MMJ}} | ||
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== Overview == | == Overview == | ||
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== MRI == | == MRI == | ||
* Brain [[Magnetic resonance imaging|MRI]] may be helpful in the diagnosis of hepatic encephalopathy. | * Brain [[Magnetic resonance imaging|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 in | * Findings on [[MRI]] suggestive of of hepatic encephalopathy include:<ref name="pmid20448015">{{cite journal| author=McKinney AM, Lohman BD, Sarikaya B, Uhlmann E, Spanbauer J, Singewald T et al.| title=Acute hepatic encephalopathy: diffusion-weighted and fluid-attenuated inversion recovery findings, and correlation with plasma ammonia level and clinical outcome. | journal=AJNR Am J Neuroradiol | year= 2010 | volume= 31 | issue= 8 | pages= 1471-9 | pmid=20448015 | doi=10.3174/ajnr.A2112 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20448015 }} </ref><ref name="pmid21087942">{{cite journal| author=U-King-Im JM, Yu E, Bartlett E, Soobrah R, Kucharczyk W| title=Acute hyperammonemic encephalopathy in adults: imaging findings. | journal=AJNR Am J Neuroradiol | year= 2011 | volume= 32 | issue= 2 | pages= 413-8 | pmid=21087942 | doi=10.3174/ajnr.A2290 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21087942 }} </ref><ref name="pmid21257930">{{cite journal| author=Hegde AN, Mohan S, Lath N, Lim CC| title=Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. | journal=Radiographics | year= 2011 | volume= 31 | issue= 1 | pages= 5-30 | pmid=21257930 | doi=10.1148/rg.311105041 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21257930 }} </ref><ref name="pmid26860677">{{cite journal| author=Benson JC, Payabvash S, Thalken GL, Alonso J, Rykken J, Ott F et al.| title=Delineation of microhemorrhage in acute hepatic encephalopathy using susceptibility-weighted imaging. | journal=Eur J Radiol | year= 2016 | volume= 85 | issue= 3 | pages= 629-34 | pmid=26860677 | doi=10.1016/j.ejrad.2015.12.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26860677 }} </ref> | ||
** Symmetric high signal within the [[insula]], posterior limbs of the [[internal capsule]], [[thalamus]], and [[cingulate gyrus]] | ** 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'''. | ||
[[File:Acute-severe-hepatic-encephalopathy.jpg|500px|thumb|left|MRI showing brain edema in hepatic encephalopathy [https://images.radiopaedia.org/images/15232173/6158dcd2023c2d5990e7966acfb839_big_gallery.jpg Source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340]]] | |||
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[[File:Acute-severe-hepatic-encephalopathy axial FLAIR.jpg|500px|thumb|left|MRI showing brain edema in hepatic encephalopathy [https://images.radiopaedia.org/images/15232747/32bec77e21d03275f65654fc725111_big_gallery.jpg Source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340]]] | |||
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==References== | ==References== | ||
Latest revision as of 14:19, 10 January 2018
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Hepatic encephalopathy Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatic encephalopathy MRI On the Web |
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American Roentgen Ray Society Images of Hepatic encephalopathy MRI |
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Risk calculators and risk factors for Hepatic encephalopathy MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ;Mohamadmostafa Jahansouz M.D.[2]
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
- 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.
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.