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Review
. 2023 May 25:17:1152630.
doi: 10.3389/fnins.2023.1152630. eCollection 2023.

Application of magnetic resonance imaging-related techniques in the diagnosis of sepsis-associated encephalopathy: present status and prospect

Shuhui Wu  1   2 , Yuxin Wang  3 , Yaqin Song  1   2 , Hongjie Hu  1   2 , Liang Jing  1   2 , Wei Zhu  1   2
Affiliations
Review

Application of magnetic resonance imaging-related techniques in the diagnosis of sepsis-associated encephalopathy: present status and prospect

Shuhui Wu et al. Front Neurosci. .

Abstract

Sepsis-associated encephalopathy (SAE) refers to diffuse brain dysfunction secondary to systemic infection without central nervous system infection. The early diagnosis of SAE remains a major clinical problem, and its diagnosis is still exclusionary. Magnetic resonance imaging (MRI) related techniques, such as magnetic resonance spectroscopy (MRS), molecular MRI (mMRI), arterial spin-labeling (ASL), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI), currently provide new options for the early identification of SAE. This review collected clinical and basic research and case reports related to SAE and MRI-related techniques in recent years, summarized and analyzed the basic principles and applications of MRI technology in diagnosing SAE, and provided a basis for diagnosing SAE by MRI-related techniques.

Keywords: cognitive impairment; imaging diagnosis; magnetic resonance imaging; sepsis; sepsis-associated encephalopathy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The contrast agents pass through the blood–brain barrier and penetrate the capillaries into the extravascular cellular space. The direction of infiltration is shown by the arrow. (By Figdraw, http://www.figdraw.com).
Figure 2
Figure 2
Brain magnetic resonance imaging of two patients during Sepsis-associated encephalopathy (SAE). (A,B): An 75-year-old male patient with serious pneumonia was diagnosed with SAE because of respiratory infection. MRI on day 9 showed high signal on T2-FLAIR sequence, with speckled and patchy WMH in bilateral periventricular cerebral white matter (grade 2 leukoencephalopathy). DWI showed small patchy slightly high signal in the left thalamus region. (C,D): An 79-year-old male patient with urosepsis and cystostomy was diagnosed with SAE. T2-FLAIR sequence showed increased signals in the pontocerebrum, bilateral basal ganglia, radial crown, centrum semiovale, and bilateral frontotemporal parietal lobes.
Figure 3
Figure 3
Possible role of MRI-related techniques in the diagnosis of SAE. Pink circles depict MRI parameters, blue boxes depict potential pathophysiologic mechanisms of SAE, and purple boxes depict imaging changes reported in SAE studies.
See this image and copyright information in PMC

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