Showing papers by "Juan Córdoba published in 2012"

Brain Imaging in Hepatic Encephalopathy

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.