JOURNAL BROWSE
Search
Advanced SearchSearch Tips
Pallidal Signal Intensities on T1-weighted MRI are Highly Observed in Advanced Liver Cirrhosis
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Pallidal Signal Intensities on T1-weighted MRI are Highly Observed in Advanced Liver Cirrhosis
Weon, Young-Cheol; Park, Neung-Hwa; Kim, Yang-Ho; Lee, Heun;
  PDF(new window)
 Abstract
Background: Manganese (Mn) has been found to increase the signal intensity of the globus pallidus (GP) on T1-weighted magnetic resonance images (MRI). We performed this study in order to determine the features of liver disease that correlate with pallidal signal intensities. Methods: We assessed blood Mn levels and pallidal signals in T1-weighted MRI in 49 patients with liver cirrhosis and 23 healthy controls. Results: Increased signal intensity in the GP was observed in 30 of 49 (61.2%) patients with liver cirrhosis, with the pallidal index (PI) in patients with Child-Pugh classes B and C differing significantly from the PI in controls. Multiple linear regression analysis showed that blood Mn concentrations and Child-Pugh scores in cirrhotics were significantly associated with increased PI after controlling for other confounders (p<0.05 each). Conclusions: Pallidal signals on T1-weighted MRI are mainly observed in advanced liver cirrhosis. The present study suggests that advanced liver cirrhosis may be a human model for manganism.
 Keywords
manganese;signal intensity;magnetic resonance;liver cirrhosis;pallidal index;
 Language
English
 Cited by
 References
1.
Kim Y. Neuroimaging in manganism. Neurotoxicology 2006; 27(3): 369-372. crossref(new window)

2.
Kim Y, Kim KS, Yang JS, Park IJ, Kim E, Jin Y, et al. Increase in signal intensities on T1-weighted magnetic resonance images in asymptomatic manganese- exposed workers. Neurotoxicology 1999; 20(6): 901-908.

3.
Newland MC, Ceckler TL, Kordower JH, Weiss B. Visualizing manganese in the primate basal ganglia with magnetic resonance imaging. Exp Neurol 1989; 106(3): 251-258. crossref(new window)

4.
Nelson K, Golnick J, Korn T, Angle C. Manganese encephalopathy: utility of early magnetic resonance imaging. Br J Ind Med 1993; 50(6): 510- 513.

5.
Butterworth RF, Spahr L, Fontaine S, Layrargues GP. Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy. Metab Brain Dis 1995; 10(4): 259-267. crossref(new window)

6.
Hauser RA, Zesiewicz TA, Martinez C, Rosemurgy AS, Olanow CW. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996; 23(2): 95-98.

7.
Saito H, Ejima A. Liver dysfunction and probable manganese accumulation in the brainstem and basal ganglia. J Neurol Neurosurg Psychiatry 1995; 58(6): 760-761.

8.
Krieger D, Krieger S, Jansen O, Gass P, Theilmann L, Lichtnecker H. Manganese and chronic hepatic encephalopathy. Lancet 1995; 346(8970): 270-274. crossref(new window)

9.
Maeda H, Sato M, Yoshikawa A, Kimura M, Sonomura T, Terada M, et al. Brain MR imaging in patients with hepatic cirrhosis: relationship between high intensity signal in basal ganglia on T1-weighted images and elemental concentrations in brain. Neuroradiology 1997; 39(8): 546-550. crossref(new window)

10.
Inoue E, Shinich H, Narumi Y, Fujita M, Kuriyama K, Kadota T, et al. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images. Radiology 1991; 179(2): 551-555. crossref(new window)

11.
Kulisevsky J, Pujol J, Balanzo J, Junque C, Deus J, Capdevilla A, et al. Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patients: clinical correlations. Hepatology 1992; 16(6): 1382- 1388. crossref(new window)

12.
Pujol A, Pujol J, Graus F, Rimola A, Peri J, Mercader JM, et al. Hyperintense globus pallidus on T1-weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 1993; 43(1): 65-69. crossref(new window)

13.
Rose C, Butterworth RF, Zayed J, Normandin L, Todd K, Michalak A, et al. Manganese deposition in basal ganglia structures results from both portalsystemic shunting and liver dysfunction. Gastroenterology 1999; 117(3): 640-644. crossref(new window)

14.
Thuluvath PJ, Edwin D, Yue NC, deVilliers C, Hochman S, Klein A. Increased signals seen in globus pallidus in T1-weighted magnetic resonance imaging in cirrhotics are not suggestive of chronic hepatic encephalopathy. Hepatology 1995; 21(2): 440-442.

15.
Weissenborn K, Ehrenheim C, Hori A, Kubicka S, Manns MP. Pallidal lesions in patients with liver cirrhosis: clinical and MRI evaluation. Metab Brain Dis 1995; 10(3): 219-231. crossref(new window)

16.
Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the esophagus for bleeding esophageal varices. Br J Surg 1973; 60(8): 646-649. crossref(new window)

17.
Baldwin S, Deaker M, Maher W. Low volume microwave digestion of marine biological tissues for the measurement of trace elements. Analyst 1994; 119(8): 1701-1704. crossref(new window)

18.
Francois B, Oliver G, Josiane A, Francis P. Determination of manganese in biological materials by electrothermal atomic absorption spectrometry, a review. Clinical Chem 1988; 34(2): 227-234.

19.
Choi Y, Park JK, Park NH, Shin JW, Yoo C-I, Lee CR, et al. Whole blood and red blood cell manganese reflected signal intensities of T1-weighted MRI better than plasma manganese in liver cirrhotics. J Occup Health 2005; 47(1): 68-73. crossref(new window)

20.
Bang S-J, Choi SH, Park NH, Shin JW, Choy N, Kim SH, et al. High pallidal T1 signal is rarely observed in obstructive jaundice, but is frequently observed in liver cirrhosis. J Occup Health 2007; 49(4): 268-272. crossref(new window)

21.
Park NH, Park JK, Choi Y, Yoo C-I, Lee CR, Lee H, et al. Whole blood manganese correlates with high signal intensities on T1-weighted MRI in patients with liver cirrhosis. Neurotoxicology 2003; 24(6): 909-915. crossref(new window)

22.
Kim J, Kim J-M, Kim YK, Shin JW, Choi SH, Kim SE, et al. Dopamine transporter SPECT of a liver cirrhotic with atypical parkinsonism. Ind Health 2007; 45(3): 497-500. crossref(new window)

23.
Yanai S, Minami T, Sonoda K, Gondo K, Tasaki K, Hijii T, et al.: Patent ductus venosus associated with a hyperintense globus pallidum on T1- weighted magnetic resonance imaging and pulmonary hypertension. Eur J Pediatr 1995; 154(7): 526-529. crossref(new window)

24.
Ihara K, Hijii T, Kuromaru R, Ariyoshi M, Kira R, Fukushige J, et al. High-intensity basal ganglia lesions on T1-weighted images in two toddlers with elevated blood manganese with portosystemic shunts. Neuroradiology 1999; 41(3): 195- 198. crossref(new window)

25.
Nolte W, Wiltfang J, Schindler CG, Unterberg K, Finkenstaedt M, Niedmann PD, et al. Bright basal ganglia in T1-weighted magnetic resonance images are frequent in patients with portal vein thrombosis without liver cirrhosis and not suggestive of hepatic encephalopathy. J Hepatol 1998; 29(3): 443-449. crossref(new window)

26.
Fukuzawa T, Matsutani S, Maruyama H, Akiike T, Saisho H, Hattori T. Magnetic resonance images of the globus pallidus in patients with idiopathic portal hypertension: a quantitative analysis of the relationship between signal intensity and the grade of portosystemic shunt. J Gastroenterol Hepatol 2006; 21(5): 902-907. crossref(new window)

27.
Kim JM, Kim JS, Jeong SH, Kim YK, Kim SE, Kim SH, et al. Dopaminergic neuronal integrity in parkinsonism associated with liver cirrhosis. Neurotoxicology 2010; 31(4): 351-355. crossref(new window)

28.
Klos KJ, Ahlskog JE, Kumar N, Cambern S, Butz J, Burritt M, et al. Brain metal concentrations in chronic liver failure patients and pallidal T1 MRI hyperintensity. Neurology 2006; 67(11): 1984-1989. crossref(new window)

29.
Racette BA, Antenor JA, McGee-Minninch L, Moerlein SM, Videen TO, Kotagal V, et al. [18F]FDOPA PET and clinical features in parkinsonism due to manganism. Mov Disord 2005; 20(4): 492-496. crossref(new window)