Publication Name	World Journal of Radiology
Manuscript ID	120177
Country	United States

Category	Radiology, Nuclear Medicine & Medical Imaging
Manuscript Type	Correspondence
Article Title	Letter to the Editor: Hemodynamic role in hepatic encephalopathy pathogenesis following transjugular intrahepatic portosystemic shunt placement
Manuscript Source	Unsolicited Manuscript
All Author List	John Halphen Jr, Yash S Dayal, Cameron Laurie, Mohadese Ahmadzade, David Wynne and Mohammad Ghasemi-Rad
Funding Agency and Grant Number
Corresponding Author	Mohammad Ghasemi-Rad, Department of Radiology, Section of Vascular and Interventional Radiology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States. mohammad.ghasemirad@bcm.edu
Key Words	Arterial spin labeling; Cerebral blood flow; Hemodynamic; Hepatic encephalopathy; Digit symbol substitution test; Resting-state functional magnetic resonance imaging; Transjugular intrahepatic portosystemic shunt
Core Tip	The pathogenesis of hepatic encephalopathy (HE) following transjugular intrahepatic portosystemic shunting (TIPS) remains incompletely understood. While hyperammonemia is classically implicated as the driver of HE development, Zhuang et al also suggest that postoperative hemodynamic changes play a key role. Using three-dimensional arterial spin labeling and resting-state functional magnetic resonance imaging, the authors demonstrate brain-region-specific alterations in cerebral blood flow and resting spontaneous brain activity, as measured by amplitude of low-frequency fluctuation, following TIPS placement. Their findings challenge the conventional understanding of post-TIPS placement HE and highlight the diagnostic potential of resting-state functional magnetic resonance imaging for characterizing HE during the early postoperative period.
Citation	Halphen Jr J, Dayal YS, Laurie C, Ahmadzade M, Wynne D, Ghasemi-Rad M. Letter to the Editor: Hemodynamic role in hepatic encephalopathy pathogenesis following transjugular intrahepatic portosystemic shunt placement. World J Radiol 2026; In press

Received	2026-02-24 09:31
Peer-Review Started	2026-02-24 09:31
First Decision by Editorial Office Director	2026-03-12 08:35
Return for Revision	2026-03-12 08:35
Revised	2026-03-17 03:42
Publication Fee Transferred
Second Decision by Editor	2026-05-06 03:17
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-05-06 08:01
Articles in Press	2026-05-06 08:01
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8470 (online)
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