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MR Imaging Findings in Hepatic Encephalopathy
A. Rovira, J. Alonso and J. Córdoba
American Journal of Neuroradiology October 2008, 29 (9) 1612-1621; DOI: https://doi.org/10.3174/ajnr.A1139
A. Rovira
J. Alonso
References
- ↵Cordoba J, Blei AT. Hepatic encephalopathy. In: Shiff ER, Sorrell MF, Maddrey WC, eds. Shiff's Diseases of the Liver. Philadelphia: Lippincott Williams & Wilkins;2003 :595–623
- ↵Ferenci P, Lockwood A, Mullen K, et al. Hepatic encephalopathy: definition, nomenclature, diagnosis, and quantification—final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 2002;35:716–21
- ↵Weissenborn K. Diagnosis of encephalopathy. Digestion 1998;59 (suppl 2):22–24
- Cadranel JF, Lebiez E, Di Martino V, et al. Focal neurological signs in hepatic encephalopathy in cirrhotic patients: an underestimated entity? Am J Gastroenterol 2001;96:515–18
- Krieger S, Jauss M, Jansen O, et al. Neuropsychiatric profile and hyperintense globus pallidus on T1-weighted magnetic resonance images in liver cirrhosis. Gastroenterology 1996;111:147–55
- ↵Adams RD, Foley JM. The neurological disorder associated with liver disease. Res Publ Assoc Res Nerv Ment Dis 1953;32:198–237
- ↵Ortiz M, Jacas C, Cordoba J. Minimal hepatic encephalopathy: diagnosis, clinical significance and recommendations. J Hepatol 2005;42 (suppl 1):S45–S53
- ↵Amodio P, Montagnese S, Gatta A, et al. Characteristics of minimal hepatic encephalopathy. Metab Brain Dis 2004;19:253–67
- ↵Weissenborn K, Ennen JC, Schomerus H, et al. Neuropsychological characterization of hepatic encephalopathy. J Hepatol 2001;34:768–73
- ↵Weissenborn K, Bokemeyer M, Ahl B, et al. Functional imaging of the brain in patients with liver cirrhosis. Metab Brain Dis 2004;19:269–80
- ↵Albrecht J, Jones EA. Hepatic encephalopathy: molecular mechanisms underlying the clinical syndrome. J Neurol Sci 1999;170:138–46
- ↵Butterworth RF. The neurobiology of hepatic encephalopathy. Semin Liver Dis 1996;16:235–44
- ↵Hazell AS. Astrocytes and manganese neurotoxicity. Neurochem Int 2002;41:271–77
- Normandin L, Hazell AS. Manganese neurotoxicity: an update of pathophysiologic mechanisms. Metab Brain Dis 2002;17:375–87
- Butterworth RF. Pathophysiology of hepatic encephalopathy: a new look at ammonia. Metab Brain Dis 2002;17:221–27
- ↵
- ↵Papavasiliou PS, Miller ST, Cotzias GC. Role of liver in regulating distribution and excretion of manganese. Am J Physiol 1966;211:211–16
- ↵
- Wedler FC, Tom R. Interactions of Mn (II) with mammalian glutamine synthetase. In: Schramm VL, Wedler FC, eds. Manganese in Metabolism and Enzyme Function. New York: Academic Press;1986 :221–38
- ↵Bentle LA, Lardy HA. Interaction of anions and divalent metal ions with phosphoenolpyruvate carboxykinase. J Biol Chem 1976;251:2916–21
- ↵Couper J. On the effects of black oxide of manganese when inhaled into the lungs. Br Ann Med Pharmacol 1837;1:41–42
- ↵Mena I, Marin O, Fuenzalida S, et al. Chronic manganese poisoning: clinical picture and manganese turnover. Neurology 1967;17:128–36
- Barbeau A. Manganese and extrapyramidal disorders (a critical review and tribute to Dr. George C. Cotzias). Neurotoxicology 1984;5:13–35
- ↵Emara AM, el-Ghawabi SH, Madkour OI, et al. Chronic manganese poisoning in the dry battery industry. Br J Ind Med 1971;28:78–82
- ↵
- Olanow CW, Good PF, Shinotoh H, et al. Manganese intoxication in the rhesus monkey: a clinical, imaging, pathologic, and biochemical study. Neurology 1996;46:492–98
- ↵Spadoni F, Stefani A, Morello M, et al. Selective vulnerability of pallidal neurons in the early phases of manganese intoxication. Exp Brain Res 2000;135:544–51
- ↵Rose C, Butterworth RF, Zayed J, et al. Manganese deposition in basal ganglia structures results from both portal-systemic shunting and liver dysfunction. Gastroenterology 1999;117:640–44
- ↵Burkhard PR, Delavelle J, Pasquier RD, et al. Chronic parkinsonism associated with cirrhosis: a distinct subset of acquired hepatocerebral degeneration. Arch Neurol 2003;60:521–28
- ↵Olanow CW. Manganese-induced parkinsonism and Parkinson's disease. Ann N Y Acad Sci 2004;1012:209–23
- Shulman LM, Minagar A, Weiner WJ. Reversal of parkinsonism following liver transplantation. Neurology 2003;60:519
- Calne D, Chu N, Huang C, et al. Manganism and idiopathic parkinsonism: similarities and differences. Neurology 1994;44:1583–86
- ↵Klos KJ, Ahlskog JE, Josephs KA, et al. Neurologic spectrum of chronic liver failure and basal ganglia T1 hyperintensity on magnetic resonance imaging: probable manganese neurotoxicity. Arch Neurol 2005;62:1385–90
- ↵Morgan MY. Noninvasive neuroinvestigation in liver disease. Semin Liver Dis 1996;16:293–314
- ↵Pujol A, Pujol J, Graus F, et al. Hyperintense globus pallidus on T1-weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 1993;43:65–69
- ↵Krieger S, Jauss M, Jansen O, et al. MRI findings in chronic hepatic encephalopathy depend on portosystemic shunt: results of a controlled prospective clinical investigation. J Hepatol 1997;27:121–26
- ↵
- ↵Butterworth RF, Spahr L, Fontaine S, et al. Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy. Metab Brain Dis 1995;10:259–67
- ↵Spahr L, Butterworth RF, Fontaine S, et al. Increased blood manganese in cirrhotic patients: relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms. Hepatology 1996;24:1116–20
- Hauser RA, Zesiewicz TA, Rosemurgy AS, et al. Manganese intoxication and chronic liver failure. Ann Neurol 1994;36:871–75
- ↵Katsuragi T, Iseki E, Kosaka K, et al. Cerebrospinal fluid manganese concentrations in patients with symmetric pallidal hyperintensities on T1 weighted MRI. J Neurol Neurosurg Psychiatry 1999;66:551–52
- ↵Pomier-Layrargues G, Spahr L, Butterworth RF. Increased manganese concentrations in pallidum of cirrhotic patients. Lancet 1995;345:735
- ↵Krieger D, Krieger S, Jansen O, et al. Manganese and chronic hepatic encephalopathy. Lancet 1995;346:270–74
- ↵Mirowitz SA, Westrich TJ, Hirsch JD. Hyperintense basal ganglia on T1-weighted MR images in patients receiving parenteral nutrition. Radiology 1991;181:117–20
- Nagatomo S, Umehara F, Hanada K, et al. Manganese intoxication during total parenteral nutrition: report of two cases and review of the literature. J Neurol Sci 1999;162:102–05
- ↵Mirowitz SA, Westrich TG. Basal ganglia signal intensity alterations: reversal after discontinuation of parenteral manganese administration. Radiology 1992;185:535–36
- ↵Ejima A, Imamura T, Nakamura S, et al. Manganese intoxication during total parenteral nutrition. Lancet 1992;339:426
- ↵Josephs KA, Ahlskog JE, Klos KJ, et al. Neurologic manifestations in welders with pallidal MRI T1 hyperintensity. Neurology 2005;64:2033–39
- ↵
- Mínguez B, García-Pagán JC, Bosch J, et al. Noncirrhotic portal vein thrombosis exhibits neuropsychological and MR changes consistent with minimal hepatic encephalopathy. Hepatology 2006;43:707–14
- ↵
- ↵Devenyi AG, Barron TF, Mamourian AC. Dystonia, hyperintense basal ganglia, and high whole blood manganese levels in Alagille's syndrome. Gastroenterology 1994;106:1068–71
- ↵Lai PH, Chen C, Liang HL, et al. Hyperintense basal ganglia on T1-weighted MR imaging. AJR Am J Roentgenol 1999;172:1109–15
- ↵Lockwood AH, Weissenborn K, Butterworth RF. An image of the brain in patients with liver disease. Curr Opin Neurol 1997;10:525–33
- ↵Weissenborn K, Ehrenheim C, Hori A, et al. Pallidal lesions in patients with liver cirrhosis: clinical and MRI evaluation. Metab Brain Dis 1995;10:219–31
- ↵Córdoba J, Alonso J, Rovira A, et al. The development of low-grade cerebral edema in cirrhosis is supported by the evolution of (1)H-magnetic resonance abnormalities after liver transplantation. J Hepatol 2001;35:598–604
- ↵Cordoba J, Olive G, Alonso J, et al. Improvement of magnetic resonance spectroscopic abnormalities but not pallidal hyperintensity followed amelioration of hepatic encephalopathy after occlusion of a large spleno-renal shunt. J Hepatol 2001;34:176–78
- ↵Naegele T, Grodd W, Viebahn R, et al. MR imaging and 1H spectroscopy of brain metabolites in hepatic encephalopathy: time-course of renormalization after liver transplantation. Radiology 2000;216:683–91
- ↵Cooper JL, Plum F. Biochemistry and physiology of brain ammonia. Physiol Rev 1987;67:440–519
- ↵Lockwood AH, Yap EW, Wong WH. Cerebral ammonia metabolism in patients with severe liver disease and minimal hepatic encephalopathy. J Cereb Blood Flow Metab 1991;11:337–41
- ↵Norenberg MD. Astroglial dysfunction in hepatic encephalopathy. Metab Brain Dis 1998;13:319–35
- ↵Martinez-Hernandez A, Bell KP, Norenberg MD. Glutamine synthetase: glial localization in brain. Science 1977;195:1356–85
- ↵Donovan JP, Shafer DF, Shaw BW Jr, et al. Cerebral oedema and increased intracranial pressure in chronic liver disease. Lancet 1998;351:719–21
- ↵McManus ML, Churchwell KB, Strange K. Regulation of cell volume in health and disease. N Engl J Med 1995;333:1260–66
- ↵Butterworth RF, Giguere JF, Michaud J, et al. Ammonia: key factor in the pathogenesis of hepatic encephalopathy. Neurochem Pathol 1987;6:1–12
- ↵Haussinger D, Laubenberger J, Dahl S, et al. Proton magnetic resonance spectroscopy studies on human brain myoinositol in hypo-osmolarity and hepatic encephalopathy. Gastroenterology 1994;107:1475–80
- ↵
- Laubenberger J, Häussinger D, Bayer S, et al. Proton magnetic resonance spectroscopy of the brain in symptomatic and asymptomatic patients with liver cirrhosis. Gastroenterology 1997;112:1610–16
- Geissler A, Lock G, Fründ R, et al. Cerebral abnormalities in patients with cirrhosis detected by proton magnetic resonance spectroscopy and magnetic resonance imaging. Hepatology 1997;25:48–54
- Ross BD, Jacobson S, Villamil F, et al. Subclinical hepatic encephalopathy: proton MR spectroscopic abnormalities. Radiology 1994;193:457–63
- Kreis R, Ross BD, Farrow NA, et al. Metabolic disorders of the brain in chronic hepatic encephalopathy detected with H-1 MR spectroscopy. Radiology 1992;182:19–27
- ↵
- ↵Córdoba J, Gottstein J, Blei AT. Glutamine, myo-inositol, and organic brain osmolytes after portocaval anastomosis in the rat: implications for ammonia-induced brain edema. Hepatology 1996;24:919–23
- ↵Thomas MA, Huda A, Guze B, et al. Cerebral 1H MR spectroscopy and neurophsychologic status of patients with hepatic encephalopathy. AJR Am J Roentgenol 1998;171:1123–30
- ↵
- ↵Córdoba J, Blei AT. Brain edema and hepatic encephalopathy. Semin Liver Dis 1996;16:271–80
- ↵Haussinge D, Kircheis G, Fischer R, et al. Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema? J Hepatol 2000;32:1035–38
- ↵
- ↵Swain MS, Blei AT, Butterworth RF, et al. Intracellular pH rises in astrocytes swell after portocaval anastomosis in rats. Am J Physiol 1991;261:R1491–96
- ↵Norenberg MD. The astrocyte in liver disease. In: Fedoroff S, Hertz L, eds. Advances in Cellular Neurobiology. New York: Academic Press;1981 :303–52
- ↵Iwasa M, Kinosada Y, Nakatsuka A, et al. Magnetization transfer contrast of various regions of the brain in liver cirrhosis. AJNR Am J Neuroradiol 1999;20:652–54
- ↵Rovira A, Grivé E, Pedraza S, et al. Magnetization transfer ratio values and proton MR spectroscopy of normal-appearing cerebral white matter in patients with liver cirrhosis. AJNR Am J Neuroradiol 2001;22:1137–42
- ↵Rovira A, Cordoba J, Sanpedro F, et al. Normalization of T2 signal abnormalities in hemispheric white matter with liver transplant. Neurology 2002;9:335–41
- ↵Lodi R, Tonon C, Stracciari A, et al. Diffusion MRI shows increased water apparent diffusion coefficient in the brains of cirrhotics. Neurology 2004;62:762–66
- ↵Kale RA, Gupta RK, Saraswat VA, et al. Demonstration of interstitial cerebral edema with diffusion tensor MR imaging in type C hepatic encephalopathy. Hepatology 2006;43:698–706
- ↵Wolf SD, Balaban RS. Magnetization transfer imaging: practical aspects and clinical applications. Radiology 1994;192:593–99
- ↵Dousset V, Grossman RI, Ramer KN, et al. Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 1992;182:483–91
- Dousset V, Brochet B, Vital A, et al. Lysolecithin-induced demyelination in primates: preliminary in vivo study with MR and magnetization transfer. AJNR Am J Neuroradiol 1995;16:225–31
- Dousset V, Armand JP, Lacoste D, et al. Magnetization transfer study of HIV encephalitis and progressive multifocal leukoencephalopathy. AJNR Am J Neuroradiol 1997;18:895–901
- van Waesberghe JH, van Walderveen MA, Castelijns JA, et al. Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spin-echo and magnetization transfer MR. AJNR Am J Neuroradiol 1998;19:675–83
- ↵Rovira A, Alonso J, Cucurella G, et al. Evolution of multiple sclerosis lesions on serial contrast-enhanced T1-weighted and magnetization-transfer MR images. AJNR Am J Neuroradiol 1999;20:1939–45
- ↵
- ↵Lee YC, Markus R, Hughes A. MRI in ALS: corticospinal tract hyperintensity. Neurology 2003;61:1600
- ↵Rydberg JN, Hammond CA, Grimm RC, et al. Initial experience in MR imaging of the brain with a fast fluid-attenuated inversion-recovery pulse sequence. Radiology 1994;193:173–80
- ↵Mirowitz S, Sartor K, Gado M, et al. Focal signal-intensity variations in the posterior internal capsule: normal MR findings and distinction from pathological findings. Radiology 1989;172:535–39
- ↵Gawne-Cain ML, Silver NC, Moseley IF, et al. Fast FLAIR of the brain: the range of appearances in normal subjects and its application to quantification of white-matter disease. Neuroradiology 1997;39:243–49
- ↵
- ↵Sarchielli P, Pelliccioli GP, Tarducci R, et al. Magnetic resonance imaging and 1H-magnetic resonance spectroscopy in amyotrophic lateral sclerosis. Neuroradiology 2001;43:189–97
- ↵Shaw PJ, Eggett CJ. Molecular factors underlying selective vulnerability of motor neurons to neurodegeneration in amyotrophic lateral sclerosis. J Neurol 2000;247:17–27
- Vogels BA, Maas MA, Daalhuisen J, et al. Memantine, an non-competitive NMDA-receptor antagonist improves hyperammonemia-induced encephalopathy and acute hepatic encephalopathy in rats. Hepatology 1997;25:820–27
- ↵Knecht K, Michalak A, Rose C, et al. Decreased glutamate transporter (GLT-1) expression in frontal cortex of rats with acute liver failure. Neurosci Lett 1997;229:201–03
- ↵Weber M, Eisen AA. Magnetic stimulation of the central and peripheral nervous systems. Muscle Nerve 2002;25:160–75
- ↵de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study—The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 2001;70:9–14
- ↵Mínguez B, Rovira A, Alonso J, et al. Decrease in the volume of white matter lesions with improvement of hepatic encephalopathy. AJNR Am J Neuroradiol 2007;28:1499–500
- ↵
- ↵Schmidt R, Enzinger C, Ropele S, et al, for the Austrian Stroke Prevention Study. Progression of cerebral white matter lesions: 6-year results of the Austrian Stroke Prevention Study. Lancet 2003;361:2046–48
- Taylor WD, MacFall JR, Provenzale JM, et al. Serial MR imaging of volumes of hyperintense white matter lesions in elderly patients: correlation with vascular risk factors. AJR Am J Roentgenol 2003;181:571–76
- ↵Dufouil C, Chalmers J, Coskun O, et al. Effects of blood pressure lowering on cerebral white matter hyperintensities in patients with stroke: the PROGRESS (Perindopril Protection Against Recurrent Stroke Study) Magnetic Resonance Imaging Substudy. Circulation 2005;112:1644–50. Epub 2005 Sep 6
- ↵Miese F, Kircheis G, Wittsack HJ, et al. 1H-MR spectroscopy, magnetization transfer, and diffusion-weighted imaging in alcoholic and nonalcoholic patients with cirrhosis with hepatic encephalopathy. AJNR Am J Neuroradiol 2006;27:1019–26
- ↵Schaefer PW, Grant PE, Gonzalez RG. Diffusion-weighted MR imaging of the brain. Radiology 2000;217:331–45
- ↵Ziylan YZ, Uzum G, Bernard G, et al. Changes in the permeability of the blood-brain barrier in acute hyperammonemia: effect of dexamethasone. Mol Chem Neuropathol 1993;20:203–18
- ↵Hazell AS, Normandin L, Norenberg MD, et al. Alzheimer type II astrocytic changes following sub-acute exposure to manganese and its prevention by antioxidant treatment. Neurosci Lett 2006;396:167–71
- ↵
- ↵Eng LF, Ghirnikar RS, Lee YL. Glial fibrillary acidic protein: GFAP-thirty-one years (1969–2000). Neurochem Res 2000;25:1439–51
- ↵Chen KC, Nicholson C. Changes in brain cell shape create residual extracellular space volume and explain tortuosity behavior during osmotic challenge. Proc Natl Acad Sci U S A 2000;97:8306–11
- ↵Ranjan P, Mishra AM, Kale R, et al. Cytotoxic edema is responsible for raised intracranial pressure in fulminant hepatic failure: in vivo demonstration using diffusion-weighted MRI in human subjects. Metab Brain Dis 2005;20:181–92
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MR Imaging Findings in Hepatic Encephalopathy
A. Rovira, J. Alonso, J. Córdoba
American Journal of Neuroradiology Oct 2008, 29 (9) 1612-1621; DOI: 10.3174/ajnr.A1139
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