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Brain MRI changes in chronic liver disease
S Skehan1, S Norris, J Hegarty
1Department of Diagnostic Imaging, St. Vincent's Hospital, Elm Park, Dublin 4, Ireland.
Abstract:
Cirrhotic patients are known to have abnormally high signal principally in the globus pallidus on non-contrast T1-weighted MRI. The purpose of this study was to relate MR changes to clinical and pathological features of chronic liver disease. We confirmed abnormally high signal in the globus pallidus on T1-weighted images in 25 of 28 patients with chronic liver disease, showing that it also occurs in patients who have not yet progressed to cirrhosis. Changes were seen in patients both with and without clinical portosystemic shunting. This abnormality is not responsible for hepatic encephalopathy. Cholestatic disease was more likely to produce marked changes than non-cholestatic disease. No statistically significant correlation was demonstrated between the severity of liver disease and the degree of MR abnormality. However, marked improvement in MR appearances was seen after successful liver transplantation.
Insights
Abnormal globus pallidus MRI signals occur in chronic liver disease, even before cirrhosis. These T1-weighted imaging changes can improve after liver transplantation.
Area of Science:
- Radiology
- Hepatology
- Neurology
Background:
- Patients with cirrhosis often exhibit high signal intensity in the globus pallidus on T1-weighted MRI.
- This finding is typically associated with chronic liver disease.
Purpose of the Study:
- To investigate the relationship between MRI signal changes in the globus pallidus and clinical/pathological features of chronic liver disease.
- To determine if these MRI abnormalities are present in patients before the development of cirrhosis.
Main Methods:
- Non-contrast T1-weighted Magnetic Resonance Imaging (MRI) was used.
- MR images were analyzed for signal intensity in the globus pallidus.
- Patients with various stages of chronic liver disease were included.
Main Results:
- Abnormally high globus pallidus signal on T1-weighted MRI was observed in 25 out of 28 patients with chronic liver disease.
- These changes were present in patients with and without clinical portosystemic shunting.
- Cholestatic liver disease was associated with more pronounced MRI signal changes compared to non-cholestatic disease.
- No significant correlation was found between liver disease severity and the degree of MRI abnormality.
- Significant improvement in MRI findings was noted post-liver transplantation.
Conclusions:
- High globus pallidus signal on T1-weighted MRI is a common finding in chronic liver disease, not exclusive to cirrhosis.
- These MRI changes are not the cause of hepatic encephalopathy.
- Successful liver transplantation can lead to the resolution of these globus pallidus MRI abnormalities.