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[Hyperintense brain lesions on T1-weighted MRI after parenteral nutrition]
1Department of Pediatrics, Urafune Hospital of Yokohama City University, Kanagawa.
Abstract:
We experienced five children having T1-shortening lesions in basal ganglia or thalami on magnetic resonance imaging (MRI), which were supposed to be caused by manganese (Mn) overdoses. Instead of the presence of above mentioned lesions, no neurological manifestations corresponding to them had developed in all patients. This observation suggests that a MRI is useful for detecting the side effects caused by overdoses of Mn in patients having parenteral nutrition.
Insights
Magnetic resonance imaging (MRI) detected T1-shortening lesions in children with manganese (Mn) overdose. These MRI findings indicate potential side effects in patients receiving parenteral nutrition, even without neurological symptoms.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Parenteral nutrition (PN) is a method of feeding that bypasses the gastrointestinal tract.
- Manganese (Mn) is an essential trace element, but excessive levels can be toxic.
- T1-shortening lesions on MRI are indicative of certain tissue abnormalities.
Observation:
- Five pediatric patients receiving PN presented with T1-shortening lesions in the basal ganglia and thalami on MRI.
- These lesions were suspected to be caused by manganese (Mn) overdose.
- Crucially, none of the patients exhibited corresponding neurological symptoms.
Findings:
- MRI is a sensitive tool for detecting subclinical manganese (Mn) toxicity.
- T1-shortening lesions in the basal ganglia and thalami can occur in pediatric patients with manganese overdose.
- The absence of neurological manifestations does not rule out manganese toxicity.
Implications:
- Early detection of manganese (Mn) toxicity through MRI can prevent potential long-term neurological damage.
- This highlights the importance of monitoring manganese levels in patients on long-term parenteral nutrition.
- MRI findings of T1-shortening lesions should prompt investigation into manganese exposure in pediatric patients.