Cerebral Magnetic Resonance Imaging in Patients with Chronic Liver Disease

Overview

Journal Metab Brain Dis

Publisher Springer

Specialties Endocrinology
Neurology

Date 1999 Feb 12

PMID 10206820

Citations 10

Authors

M Y Morgan

Affiliations

Soon will be listed here.

Abstract

Bilateral, symmetrical hyperintensity of the globus pallidus is observed in T1-weighted cerebral magnetic resonance images in from 52 to 100% of patients with chronic liver disease. No significant relationship exists between the presence of these cerebral changes in image signal intensity and the patients' neuropsychiatric status. However, their presence significantly relates to both the severity of the liver disease and the presence and degree of portal-systemic shunting of blood. This shortening of the T1-relaxation time is associated with pallidal deposition of manganese most likely reflecting the presence of an adaptive process designed to improve the efficacy of ammonia detoxification by astrocytes. Future studies employing magnetic resonance imaging techniques to obtain information on cerebral function or combined with magnetic resonance spectroscopy to obtain localized biochemical information might further our understanding of the pathogenesis of hepatic encephalopathy in cirrhotic patients.

Citing Articles

Diffusion-weighted imaging in acute hyperammonemic encephalopathy.

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A systematic review and meta-analysis of the use of oral zinc in the treatment of hepatic encephalopathy.

Chavez-Tapia N, Cesar-Arce A, Barrientos-Gutierrez T, Villegas-Lopez F, Mendez-Sanchez N, Uribe M Nutr J. 2013; 12:74.

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Biomarkers of manganese intoxication.

Zheng W, Fu S, Dydak U, Cowan D Neurotoxicology. 2010; 32(1):1-8.

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Relationship between changes in brain MRI and (1)H-MRS, severity of chronic liver damage, and recovery after liver transplantation.

Long L, Li X, Huang Z, Jiang Y, Fu S, Zheng W Exp Biol Med (Maywood). 2009; 234(9):1075-85.

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Acquired hepatocerebral degeneration.

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References

Gomori J, Grossman R, Shields J, Augsburger J, Joseph P, DeSimeone D . Choroidal melanomas: correlation of NMR spectroscopy and MR imaging. Radiology. 1986; 158(2):443-5. DOI: 10.1148/radiology.158.2.3941871. View

Krieger D, Krieger S, Jansen O, Gass P, Theilmann L, Lichtnecker H . Manganese and chronic hepatic encephalopathy. Lancet. 1995; 346(8970):270-4. DOI: 10.1016/s0140-6736(95)92164-8. View

Wedler F, Denman R . Glutamine synthetase: the major Mn(II) enzyme in mammalian brain. Curr Top Cell Regul. 1984; 24:153-69. DOI: 10.1016/b978-0-12-152824-9.50021-6. View

Markesbery W, Ehmann W, Hossain T, Alauddin M . Brain manganese concentrations in human aging and Alzheimer's disease. Neurotoxicology. 1984; 5(1):49-57. View

Finlayson M, Superville B . Distribution of cerebral lesions in acquired hepatocerebral degeneration. Brain. 1981; 104(Pt 1):79-95. DOI: 10.1093/brain/104.1.79. View

Versieck J, Barbier F, Speecke A, Hoste J . Manganese, copper, and zinc concentrations in serum and packed blood cells during acute hepatitis, chronic hepatitis, and posthepatitic cirrhosis. Clin Chem. 1974; 20(9):1141-5. View

Pomier-Layrargues G, Spahr L, Butterworth R . Increased manganese concentrations in pallidum of cirrhotic patients. Lancet. 1995; 345(8951):735. DOI: 10.1016/s0140-6736(95)90909-5. View

Barbeau A . Manganese and extrapyramidal disorders (a critical review and tribute to Dr. George C. Cotzias). Neurotoxicology. 1984; 5(1):13-35. View

Brunberg J, Kanal E, Hirsch W, Van Thiel D . Chronic acquired hepatic failure: MR imaging of the brain at 1.5 T. AJNR Am J Neuroradiol. 1991; 12(5):909-14. PMC: 8333503. View

10.

BIRD E, ANTON A, Bullock B . The effect of manganese inhalation on basal ganglia dopamine concentrations in rhesus monkey. Neurotoxicology. 1984; 5(1):59-65. View

11.

Moore J, Dunk A, Crawford J, Deans H, Besson J, de Lacey G . Neuropsychological deficits and morphological MRI brain scan abnormalities in apparently healthy non-encephalopathic patients with cirrhosis. A controlled study. J Hepatol. 1989; 9(3):319-25. DOI: 10.1016/0168-8278(89)90140-2. View

12.

Seth P, CHANDRA S . Neurotransmitters and neurotransmitter receptors in developing and adult rats during manganese poisoning. Neurotoxicology. 1984; 5(1):67-76. View

13.

Mirowitz S, Westrich T, Hirsch J . Hyperintense basal ganglia on T1-weighted MR images in patients receiving parenteral nutrition. Radiology. 1991; 181(1):117-20. DOI: 10.1148/radiology.181.1.1909445. View

14.

Farmer P, Mulakkan T . The pathogenesis of hepatic encephalopathy. Ann Clin Lab Sci. 1990; 20(2):91-7. View

15.

Pujol A, Graus F, Peri J, Mercader J, Rimola A . Hyperintensity in the globus pallidus on T1-weighted and inversion-recovery MRI: a possible marker of advanced liver disease. Neurology. 1991; 41(9):1526-7. DOI: 10.1212/wnl.41.9.1526. View

16.

Dell L, Brown M, Orrison W, Eckel C, Matwiyoff N . Physiologic intracranial calcification with hyperintensity on MR imaging: case report and experimental model. AJNR Am J Neuroradiol. 1988; 9(6):1145-8. PMC: 8331895. View

17.

Norton N, McConnell J, Zetterman R, Rodriguez-Sierra J . A quantitative evaluation of magnetic resonance image signal changes of the brain in chronic hepatic encephalopathy. J Hepatol. 1994; 21(5):764-70. DOI: 10.1016/s0168-8278(94)80236-x. View

18.

Devenyi A, Barron T, Mamourian A . Dystonia, hyperintense basal ganglia, and high whole blood manganese levels in Alagille's syndrome. Gastroenterology. 1994; 106(4):1068-71. DOI: 10.1016/0016-5085(94)90769-2. View

19.

Syh H, Chu W, Mar N, McConnell J . An image analysis on MR imaging of the brain for hepatic encephalopathy. Biomed Sci Instrum. 1991; 27:29-33. View

20.

Uchino A, Miyoshi T, Ohno M . Case report--MR imaging of chronic persistent hepatic encephalopathy. Radiat Med. 1989; 7(6):257-60. View