Brain MR imaging changes in patients with hepatic schistosomiasis japonicum without liver dysfunction

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Published on: June 8, 2017

Ying Li1, Jin Wei Qiang, Shuai Ju

  • 1Department of Radiology, Jinshan Hospital & Department of Radiology, Shanghai Medical College, Fudan University, Shanghai 201508, China.

Neurotoxicology
|January 10, 2013
PubMed
Abstract

Insights

Brain MR imaging shows manganese deposition in hepatic schistosomiasis japonicum (HSJ) patients, even without liver dysfunction. This T1-weighted hyperintensity in the basal ganglia is linked to manganese levels, suggesting portal-systemic shunting as the cause.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • T1-hyperintensity in basal ganglia (globus pallidus, substantia nigra) is linked to liver cirrhosis and manganese deposition.
  • Hepatic schistosomiasis japonicum (HSJ) patients may exhibit similar MR findings despite lacking liver dysfunction.

Purpose of the Study:

  • To characterize brain MR imaging findings in HSJ patients without liver dysfunction.
  • To investigate the association between manganese levels and brain abnormalities in HSJ.

Main Methods:

  • Brain MR and CT imaging of 18 HSJ patients and 9 controls were reviewed.
  • Signal index (SI) in globus pallidus on T1-weighted MR images was measured.
  • Whole blood manganese levels and liver function tests were analyzed.

Main Results:

  • Symmetric T1-hyperintensity in globus pallidus and substantia nigra was seen in 83.3% of HSJ patients vs. 0% of controls.
  • Significantly elevated blood manganese levels were found in HSJ patients compared to controls.
  • A significant correlation was observed between blood manganese levels and globus pallidus SI.

Conclusions:

  • Manganese deposition, likely due to portal-systemic shunting, is a frequent cause of T1-weighted basal ganglia hyperintensity in HSJ patients.
  • This finding occurs even in the absence of biochemical evidence of liver dysfunction.
  • Brain MR imaging can detect these manganese-related changes in HSJ.

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