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Magnetic Resonance Insights

Role of Magnetic Resonance in Understanding the Pathogenesis of Hepatic Encephalopathy

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Magnetic Resonance Insights 2008:2 109-122

Published on 23 Jan 2009

DOI: 10.4137/MRI.S973


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A. Huda1,2, R.K. Gupta3, N. Rajakumar2 and M.A. Thomas2

1Department of Physics, California State University, Fresno, CA 93740. 2Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095. 3Department of Radiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India.

Abstract

A spectrum of neuropsychiatric abnormalities caused by portosystemic venous shunting occurs in hepatic encephalopathy (HE) patients with or without liver dysfunction. It is not completely clear how the astrocyte swelling leads to glial-neuronal dysfunction, and how the symptoms are manifested in HE. A major goal of this work is to review the cur- rent status of information available from the existing magnetic resonance (MR) modalities including MR imaging (MRI) and MR Spectroscopy (MRS) as well as other modalities in the understanding the pathogenesis of HE. First, we discuss briefly neuron-histopathology, neurotoxins, neuropsychological and neurophysiological tests. A short review on the progress with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) is then presented. In the remaining part of the manuscript, the following topics pertinent to understanding the pathogenesis of HE are discussed: MRI, diffusion tensor imaging (DTI), one-dimensional MRS based single- and multi-voxel based spectroscopic imaging techniques and two-dimensional MRS.



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