Metabolic Brain Disease

, Volume 33, Issue 3, pp 661–671 | Cite as

Multimodal MR imaging in hepatic encephalopathy: state of the art

  • Xiao Dong Zhang
  • Long Jiang Zhang
Review Article


Hepatic encephalopathy (HE) is a neurological or neuropsychological complication due to liver failure or portosystemic shunting. The clinical manifestation is highly variable, which can exhibit mild cognitive or motor impairment initially, or gradually progress to a coma, even death, without treatment. Neuroimaging plays a critical role in uncovering the neural mechanism of HE. In particular, multimodality MR imaging is able to assess both structural and functional derangements of the brain with HE in focal or neural network perspectives. In recent years, there has been rapid development in novel MR technologies and applications to investigate the pathophysiological mechanism of HE. Therefore, it is necessary to update the latest MR findings regarding HE by use of multimodality MRI to refine and deepen our understanding of the neural traits in HE. Herein, this review highlights the latest MR imaging findings in HE to refresh our understanding of MRI application in HE.


Hepatic encephalopathy Cirrhosis Liver transplantation Magnetic resonance imaging Diffusion tensor imaging Blood oxygenation level dependent functional magnetic resonance imaging 



This work was supported by grants from National Natural Science Foundation of China (grants No. 81322020, 81230032 to L.J.Z. and No. 81701679 to X.D.Z.).

We would like to express our great thanks for Drs. Parkwood Griffith and U. Joseph Schoepf, Department of Radiology and Radiological Science, Medical University of South Carolina, USA, for their help to polish this paper.

Compliance with ethical standards

Conflict of Interest

The authors declare no conflict of interest.


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Authors and Affiliations

  1. 1.Department of RadiologyTianjin First Central Hospital, Clinical School of Tianjin Medical UniversityTianjinPeople’s Republic of China
  2. 2.Department of Medical ImagingJinling Hospital, Medical School of Nanjing UniversityNanjingPeople’s Republic of China

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