A, Baseline MR imaging study (transverse fast FLAIR T2-weighted image) of a 56-year-old patient with hepatitis C cirrhosis without overt hepatic encephalopathy.

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Presentation transcript:

A, Baseline MR imaging study (transverse fast FLAIR T2-weighted image) of a 56-year-old patient with hepatitis C cirrhosis without overt hepatic encephalopathy. A, Baseline MR imaging study (transverse fast FLAIR T2-weighted image) of a 56-year-old patient with hepatitis C cirrhosis without overt hepatic encephalopathy. Multiple focal WMLs in both cerebral hemispheres are attributed to small-vessel disease. B, A new scan obtained 2 years later during an episode of hepatic encephalopathy shows marked increase in the size of these focal WMLs. C, A new follow-up scan after complete resolution of neurologic symptoms shows a decrease in the size of the WMLs. This last scan was almost identical to the first study. A lacunar infarct is seen in the deep right frontal white matter. A. Rovira et al. AJNR Am J Neuroradiol 2008;29:1612-1621 ©2008 by American Society of Neuroradiology