Brain magnetic resonance imaging in non-alcoholic cirrhosis

Twenty-six patients with stable non-alcoholic cirrhosis and normal neurological examination were investigated by brain MRI (inversion recovery sequences) and compared with 16 controls. Brain MRI findings were correlated with the clinical and metabolic status of the patients and analysis of variance and, when necessary, co-variance was performed. Five of the patients (19%) and all 16 controls showed no MRI changes. Twelve patients (46%) showed moderately high signal in the globus pallidus (score 1), and nine (35%) very high signal (score 2). Analysis of variance showed that age was the only significant variable (P = 0.038). Analysis of co-variance after adjustment for age showed that high pallidal signal was correlated only to ammonia level (P = 0.02) but not to any other clinical or biological parameter. We conclude that T1 high intensity pallidal signal is common in non-alcoholic cirrhosis even when neurological examination is normal, but its significance remains unclear.