Hepatic encephalopathy (HE) is a frequent complication of chronic liver disease. It is defined as a characteristic functional and reversible alteration of the mental state, due to impaired liver function and/ or increased portosystemic shunting. MR imaging and proton MR spectroscopy (1H MRS) brain abnormalities have been described in association with chronic liver disease. Brain water apparent diffusion coefficient is increased in patients with chronic liver disease and may be useful in monitoring patients with HE.