Ihara H
Department of Radiology, Wakayama Medical College.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Aug;58(9):479-88.
In some patients with liver cirrhosis, the globus pallidus shows high signal intensity on T1-weighted MRI. The relationship was examined between high signal intensity on T1-weighted images and pathological conditions such as liver function, portal venous pressure and metal concentrations in brain. The signal of the globus pallidus on T1-weighted imaging became highly enhanced in accordance with prolongation of prothrombin time, deterioration of ICG R15, or decrease in choline esterase and the Fisher ratio. Furthermore, the high signal intensity was also seen in patients with high portal pressure and large varices. In histopathological study, remarkable atrophy and loss of nerve cells were observed in globus pallidus with high signal intensity on T1-weighted imaging, changes that were similar to those in with patients with manganese poisoning. The manganese concentration in autopsied globus pallidus with high signal intensity on T1-weighted imaging showed a 9.5-fold increase compared with that with normal intensity. In conclusion, the deposition of manganese in the globus pallidus, which is accompanied with the nerve cell deciduation, brings about the high signal intensity of the globus pallidus on T1-weighted MRI in patients with liver cirrhosis.
在一些肝硬化患者中，苍白球在T1加权磁共振成像（MRI）上显示高信号强度。研究了T1加权图像上的高信号强度与肝功能、门静脉压力和脑内金属浓度等病理状况之间的关系。随着凝血酶原时间延长、吲哚菁绿滞留率（ICG R15）恶化、胆碱酯酶和费希尔比率降低，T1加权成像上苍白球的信号增强。此外，门静脉高压和大静脉曲张患者也可见高信号强度。在组织病理学研究中，T1加权成像上信号强度高的苍白球可见明显的神经细胞萎缩和缺失，这些变化与锰中毒患者相似。T1加权成像上信号强度高的尸检苍白球中的锰浓度比正常强度的苍白球高9.5倍。总之，肝硬化患者苍白球中锰的沉积伴有神经细胞脱失，导致T1加权MRI上苍白球出现高信号强度。
