Chavarria Laia, Cordoba Juan
Liver Unit, Hospital Vall Hebron, Barcelona, Spain,
Metab Brain Dis. 2014 Dec;29(4):937-44. doi: 10.1007/s11011-013-9452-9. Epub 2013 Nov 21.
Brain alterations such as hepatic encephalopathy or brain edema are usually associated with liver failure. The mechanisms that lead to the generation of edema seem to be different depending on the course of liver failure (acute, chronic or acute-on-chronic liver failure). Several neuroimaging methods allow a non-invasive assessment of brain alterations in liver failure. Magnetic resonance has gained more interest due to the ability of giving information about cerebral metabolism using spectroscopy, water distribution by diffusion methods or neuronal connectivity by means of resting state magnetic resonance. These techniques have been applied to experimental models and patients with liver failure to elucidate cerebral pathways involved in the pathogenesis of hepatic encephalopathy. In the future, the development of new magnetic resonance implementations will generate handy tools for the study of the brain and get better understanding of the mechanisms that take place in liver failure. This could be useful for the early diagnosis, as well as for the design of new treatments for cerebral complications of liver failure.
诸如肝性脑病或脑水肿等脑部病变通常与肝衰竭相关。导致水肿产生的机制似乎因肝衰竭的病程（急性、慢性或慢加急性肝衰竭）而异。几种神经影像学方法可以对肝衰竭时的脑部病变进行无创评估。磁共振成像因具有通过光谱学提供脑代谢信息、通过扩散方法提供水分布信息或通过静息态磁共振成像提供神经元连接信息的能力而受到更多关注。这些技术已应用于肝衰竭的实验模型和患者，以阐明参与肝性脑病发病机制的脑通路。未来，新的磁共振成像技术的发展将为脑部研究产生便捷工具，并更好地理解肝衰竭过程中发生的机制。这对于早期诊断以及肝衰竭脑部并发症新治疗方法的设计可能会有所帮助。
