ArticleAJNR. American journal of neuroradiology2010
Acute hepatic encephalopathy: diffusion-weighted and fluid-attenuated inversion recovery findings, and correlation with plasma ammonia level and clinical outcome.
Article in AJNR. American journal of neuroradiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 105 citations in OpenAlex.
- Fulminant hyperammonemia during intensive chemotherapy in the setting of previously unrecognized partial ornithine transcarbamylase deficiency.International journal of hematology · 2026Article
- Hypoglycemic Encephalopathy Caused by Insulinoma With Reversible High Signals in the White Matter on Diffusion-Weighted MRI: A Case Report.Case reports in radiology · 2026Article
- Brain magnetic resonance imaging findings in hyperammonemic hepatic encephalopathy: A case series and literature review.Biomedical reports · 2025Article
- Janus Kinase Inhibitor: A Possible Cause of Hyperammonemic Encephalopathy?Journal of clinical neurology (Seoul, Korea) · 2025Article
- Brain CT Scan Diagnostic and Prognostic Value in Patients With Acute Liver Failure and Cerebral Edema: A Multicenter Cohort Study.Critical care explorations · 2025Article
- A Case of Hepatic Encephalopathy With Diffuse Brainstem Signal Changes on Magnetic Resonance Imaging.Cureus · 2025Article
- Brain Magnetic Resonance Imaging Radiomic Signature and Machine Learning Model Prediction of Hepatic Encephalopathy in Adult Cirrhotic Patients.Life (Basel, Switzerland) · 2025Article
- Histopathological examination of characteristic brain MRI findings in acute hyperammonemic encephalopathy: A case report and review of the literature.The neuroradiology journal · 2024Review
- Cortical Ribbon and Crossed Cerebellar Diaschisis in Subclinical Status Epilepticus: A Case Report.Cureus · 2023Article
- Brain magnetic resonance imaging radiomics features associated with hepatic encephalopathy in adult cirrhotic patients.Neuroradiology · 2022Article
- Molecular targeted therapy causes hepatic encephalopathy in patients after Transjugular intrahepatic portosystemic shunt (TIPS): A case report and literature review.Journal of interventional medicine · 2022Article
- Hepatic Encephalopathy by Manganese Deposition: A Case Report and a Review of Literature.Reviews on recent clinical trials · 2022Review
- Clinical applications of diffusion-weighted sequence in brain imaging: beyond stroke.Neuroradiology · 2022Review
- Acute Acquired Metabolic Encephalopathy Based on Diffusion MRI.Korean journal of radiology · 2021Review
- Drug-induced-acute liver failure: A critical appraisal of the thioacetamide model for the study of hepatic encephalopathy.Toxicology reports · 2021Review
- Comprehensive review of Wernicke encephalopathy: pathophysiology, clinical symptoms and imaging findings.Japanese journal of radiology · 2020Review
- Potentially Reversible and Recognizable Acute Encephalopathic Syndromes: Disease Categorization and MRI Appearances.AJNR. American journal of neuroradiology · 2020Review
- Acute Toxic Leukoencephalopathy: Etiologies, Imaging Findings, and Outcomes in 101 Patients.AJNR. American journal of neuroradiology · 2019Article
- "CHOICES": An acronym to aid in delineating potential causes of non-metabolic, non-infectious acute toxic leukoencephalopathy.European journal of radiology open · 2019Review
- Hyperammonemia in Hepatic Encephalopathy.Journal of clinical and experimental hepatology · 2018Review
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIn acute hepatic encephalopathy, MR imaging abnormalities have been described in the PVWM, thalami, and corticospinal tracts. We sought to determine characteristic regions of involvement on FLAIR and DWI, to evaluate their reversibility, and to correlate MR imaging extent with clinical severity. MATERIALS AND
methodsTwenty patients who presented clinically with acute hepatic encephalopathy and MR imaging <21 days after symptom onset were reviewed retrospectively. Two neuroradiologists recorded involved regions on FLAIR and DWI in each, measured ADC values in affected regions and NAWM, and scored the MR imaging severity/extent. The initial severity (West Haven grade), follow-up clinical severity (degree of improvement), and maximal PAL within ±8 days of MR imaging were recorded and correlated with the MR imaging severity.
resultsOn FLAIR and DWI respectively, there were abnormalities in the thalami (85%, 70%), PLIC (75%, 80%), PVWM (80%, 85%), and DBS (70%, 35%) and diffuse cortical involvement (30%, 25%). There were relatively strong significant (P < .005) correlations of FLAIR (r = 0.680, P = .001) and DWI severity (r = 0.690, P = .001) with PAL, and of PAL with the clinical outcome (r = 0.691, P = .001). Both FLAIR (r = 0.592, P = .006) and DWI (r = 0.487, P = .029) severity correlated moderately with the clinical outcome but were not significant at the P < .005 level after Bonferroni correction.
conclusionsPatients with acute hepatic encephalopathy may exhibit characteristic regions of involvement on FLAIR with DWI findings that can be reversible. The MR imaging extent on FLAIR and DWI strongly correlates with the maximal PAL, and PAL correlates well with the clinical outcome. Diffuse cortical involvement has a higher potential for neurologic sequelae but can be reversible.
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