Uremic encephalopathy: A definite diagnosis by magnetic resonance imaging?

Abstract

The aim of this study was to investigate the magnetic resonance imaging (MRI) findings for the diagnose uremic encephalopathy and describe the usefulness of MRI findings in the ultimate diagnosis of uremic encephalopathy (UE). A total of 20 patients with uremic encephalopathy admitted to the hospital were evaluated in this prospective study. The clinical manifestations, laboratory and MRI imaging findings, demographic information, and clinical outcome were analyzed for each patient. We observed that the 20 prospectively reviewed patients with UE had no involvement of the basal ganglia or the lentiform fork sign (LFS). However, two-thirds of the patients had white matter involvement, and 80% of the subjects had cerebral or cortical atrophy. The arterial blood gas (ABG) analysis revealed that 50% of the patients suffered from metabolic acidosis (n=10). The results of the present study demonstrated that although the observation of Lentiform Fork Sign and Basal Ganglia involvement in MRI of UE patients is a specific finding the absence of which does not rule out UE. Thus, simultaneous examination of clinical manifestation and laboratory test analyses, along with imaging findings, should also be taken into account.

circRNA-PTPN4 mediated regulation of FOXO3 and ZO-1 expression: implications for blood–brain barrier integrity and cognitive function in uremic encephalopathy

“…Dysfunction of the BBB has been implicated in the pathogenesis of a range of neurological disorders, underscoring its critical role as a protective interface between the brain and external milieu (Kadry et al 2020 ). Prior research has posited a potential link between UE and compromised BBB integrity, yet the underlying biological mechanisms have yet to be fully elucidated (Sina et al 2022 ). In this investigation, high-throughput sequencing techniques were employed to reveal an elevated expression of miR-301a-3p in mice with UE (Figs.…”

An Irreversible Radiological Finding of Lentiform Fork Sign in a Patient With Uremic Encephalopathy: A Case Report

“…On top of this, destructive and demyelinating lesions have also been proposed to be responsible for the pathogenesis [ 1 ]. The magnetic resonance imaging (MRI) findings show a wide range of specific features, mainly involving three main areas of the brain: (1) BG, (2) cortical and subcortical areas, and (3) multiple white matter areas [ 3 ]. Recently, the presence of lentiform fork sign (LFS) on MRI has been increasingly recognized as a meaningful imaging sign for an accurate diagnosis of UE.…”

“…Recently, the presence of lentiform fork sign (LFS) on MRI has been increasingly recognized as a meaningful imaging sign for an accurate diagnosis of UE. The hyperintense rim delineating the putamen on the T2-weighted imaging (T2WI) sequence of MRI in LFS reflects the edema of these regions [ 3 ]. Underlying metabolic acidosis is suspected to be a common trigger behind these lesions, as it has been observed in patients with normal renal function with metabolic acidosis secondary to other causes [ 4 ].…”

“…Underlying metabolic acidosis is suspected to be a common trigger behind these lesions, as it has been observed in patients with normal renal function with metabolic acidosis secondary to other causes [ 4 ]. The involvement of BG in UE is more commonly seen in patients with diabetes mellitus [ 2 , 3 ]. The clinical symptoms and radiological lesions usually show complete or partial resolution by regulating dialysis sessions, treating underlying metabolic acidosis and sepsis, controlling blood glucose levels, and removing harmful drugs like metformin [ 2 ].…”