Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping:...

The liver is a central organ for the metabolism of iron and manganese and the places where those metals are commonly deposited overlap in the brain.

To elucidate the relationship between pallidal T₁ hyperintensity and iron deposition in the deep gray matter of liver cirrhosis patients using quantitative susceptibility mapping (QSM).

Retrospective case-control study SUBJECTS: In all, 38 consecutive liver cirrhosis patients who received brain magnetic resonance imaging (MRI) as pretransplant evaluation.

QSM was reconstructed from 3D multi- or single-echo phase images at 3T. T₁ -weighted images were used for the assessment of pallidal hyperintensity and pallidal index (PI).

Patients were divided into two groups according to the presence of pallidal hyperintensity by consensus of two radiologists. Susceptibility values were acquired for five deep gray matter structures.

QSM measures were compared between two groups using the t-test. We also calculated Pearson correlations between QSM measures and PI.

In all, 26 patients showed pallidal hyperintensity (T₁ h group) and 12 did not (T₁ n group). The susceptibility of the globus pallidus (GP) in the T₁ h group (120.6 ± 38.1 ppb) was significantly lower than that in the T₁ n group (150.0 ± 35.2, P = 0.030). The susceptibility of the dentate nucleus (DN) in the T₁ h group (88.1 ± 31.0) was significantly lower than that in the T₁ n group (125.6 ± 30.6, P = 0.001). Negative correlation between the susceptibility of GP (r = -0.37, P = 0.022) and the PI, and between DN (r = -0.43, P < 0.001) and the PI was found.

Liver cirrhosis patients with pallidal T₁ hyperintensity had lower susceptibility values in the GP and DN than those without it. This suggests a possible interaction between iron and manganese in the brains of liver cirrhosis patients.

3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1342-1349.