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[Cranial MRI in the patients with chronic liver disease (CLD)]
T Nakamura1, S Saitoh, K Ikeda
1Department of Gastroenterology, Toranomon Hospital.
Abstract:
We examined cranial MRI in 62 patients with CLD. Abnormal finding that high intensity area in symmetrical bilateral basal ganglia other than globus pallidum was found on both T-1 weighted images (T1WI) and fat suppression (chemical shift selective) images. This MRI finding was observed in 32 of 41 patients with cirrhosis while 1 of 21 patients with chronic hepatitis. This MRI finding was irreversible. The incidence of this MRI finding was correlated with severity of CLD and was statistically significant between in the patients with chronic hepatitis and those with cirrhosis. The contributing factors to the incidence of this MRI finding were severity of CLD and total bilirubin level by an analysis with logistic regression model. This MRI finding was detected clearer in a fat suppression imaging than in T1WI. The cause of this MRI finding was supposed not fat related substance by the finding of fat suppression imaging. This MRI finding would be useful for prediction of severity of CLD.
Insights
A specific MRI finding in the basal ganglia is linked to chronic liver disease (CLD) severity. This irreversible finding, clearer on fat-suppression imaging, may help predict CLD progression.
Area of Science:
- Radiology
- Hepatology
- Neurology
Context:
- Chronic liver disease (CLD) encompasses conditions like cirrhosis and chronic hepatitis.
- Cranial MRI is a key diagnostic tool for neurological complications.
- Basal ganglia abnormalities can indicate metabolic encephalopathies in CLD.
Purpose:
- To investigate a specific cranial MRI finding in patients with CLD.
- To determine the correlation between this MRI finding and CLD severity.
- To assess the utility of this finding in predicting CLD progression.
Summary:
- Cranial MRI in 62 CLD patients revealed high-intensity signals in symmetrical bilateral basal ganglia (excluding globus pallidus) on T1WI and fat suppression images.
- This irreversible finding was present in 32/41 cirrhosis patients versus 1/21 chronic hepatitis patients, correlating significantly with CLD severity.
- Logistic regression identified CLD severity and total bilirubin as contributing factors. Fat suppression imaging enhanced detection and suggested a non-fat-related cause.
Impact:
- This MRI finding offers a potential non-invasive biomarker for assessing CLD severity.
- It may aid in predicting disease progression and guiding clinical management.
- The findings highlight the importance of specific MRI sequences in evaluating CLD-related neurological changes.