Table 3

Neuroimaging patterns in uraemic and hyperammonaemic encephalopathy

ImagingPatterns
Uraemic encephalopathy
 CTHypodense basal ganglia and capsules
 MRI
  • ▸ T2, FLAIR and DWI hyperintense basal ganglia, capsules and inconsistently in cortical areas

  • ▸ Additional involvement of white matter and cerebral peduncles, occipital lobes and thalami

  • ▸ Decreased N-acetyl-aspartate and an elevated lactate in the basal ganglia on MRS

 PETDecreased glucose metabolism in basal ganglia
Hyperammonaemic encephalopathy
 CTUsually normal
 MRI
  • ▸ T2, FLAIR and DWI cortical hyperintensities of the insula and cingulum

  • ▸ Increased glutamine and glutamate; low myoinositol and choline on MRS

  • DWI, diffusion-weighted imaging; FLAIR, fluid-attenuated inversion recovery; MRS, MR spectroscopy; PET, positron emission tomography.