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Brain Imaging in Hepatic Encephalopathy

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Book cover Hepatic Encephalopathy

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Neuroimaging techniques had a rapid development in the last years. Some of them, such as computed tomography or magnetic resonance, have become routine techniques. These methods have shown their usefulness in the diagnosis of hepatic encephalopathy, excluding other potential entities. In addition, these techniques provide us with useful information for the understanding of the pathogenesis of this syndrome. Magnetic resonance contributes to a better understanding of the role of manganese in the neurologic manifestations of chronic liver failure. On the other hand, these methods and specially magnetic resonance spectroscopy have allowed a better knowledge of the effects of ammonia in the brain. More sophisticated sequences of magnetic resonance imaging such as magnetization transfer, fast fluid-attenuated inversion recovery sequences, and diffusion-weighted images detect alterations that support the presence of low-grade brain edema. Furthermore, volumetric techniques allow assessing changes in brain volume associated to hepatic encephalopathy. The data obtained by the application of these methods support the development of permanent structural damage associated to this metabolic syndrome. The wide and relevant information provided by these tools made them very useful in the diagnosis of hepatic encephalopathy and support their application in monitoring and evaluating the effect of new therapies.

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Abbreviations

ADC:

Apparent diffusion coefficient

Cho:

Choline containing compounds

DWI:

Diffusion-weighted imaging

FLAIR:

Fast fluid-attenuated inversion recovery

fMRI:

Functional magnetic resonance imaging

Glx:

Glutamine/glutamate

HE:

Hepatic encephalopathy

LT:

Liver transplantation

MR:

Magnetic resonance

MT:

Magnetization transfer

PET:

Positron emission tomography

SPECT:

Single-photon emission computed tomography

WML:

White matter focal T2-weighted lesions

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Financial Support

CIBEREHD is supported by Instituto de Salud Carlos III, Madrid, Spain. Rita García-Martínez has been supported by grant CM07/00109.

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Authors and Affiliations

  1. Liver Unit, Department of Internal Medicine, Vall d’Hebron Hospital, Barcelona, 08035, Spain

    Rita García-Martínez PhD & Juan Córdoba PhD

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  1. Rita García-Martínez PhD
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  2. Juan Córdoba PhD
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Correspondence to Juan Córdoba PhD .

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  1. , Division of Gastroenterology, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, 44145, USA

    Kevin D. Mullen

  2. , Division of Gastroenterology, MetroHealth Medical Center, 2500 MetroHealth Medical Center, Cleveland, 44145, USA

    Ravi K. Prakash

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García-Martínez, R., Córdoba, J. (2012). Brain Imaging in Hepatic Encephalopathy. In: Mullen, K., Prakash, R. (eds) Hepatic Encephalopathy. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-836-8_10

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  • DOI: https://doi.org/10.1007/978-1-61779-836-8_10

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