Document Detail

Increased signals seen in globus pallidus in T1-weighted magnetic resonance imaging in cirrhotics are not suggestive of chronic hepatic encephalopathy.
MedLine Citation:
PMID:  7843718     Owner:  NLM     Status:  MEDLINE    
Increased, symmetrical signals of varying intensity in the globus pallidi on T1-weighted (T1W) images, without corresponding signals on T2-weighted (T2W) images, have been reported previously in chronic hepatic failure. It has been suggested that these signals are characteristic of chronic hepatic encephalopathy. To test this hypothesis, we evaluated the relationship of magnetic resonance imaging (MRI) abnormalities with ammonia, albumin, bilirubin, prothrombin time, ascites, clinical encephalopathy, and neuropsychological tests in 46 patients (16 with alcohol-induced cirrhosis and 30 with non-alcohol-induced cirrhosis). T1W signal and cortical atrophy were graded by a neuroradiologist in a blinded fashion. Eleven patients had no T1W signal, 18 had minimal T1W signal, and 17 had high T1W signal. Twenty-five patients had no cortical atrophy, 14 had mild atrophy, and 7 had moderate atrophy. Cortical atrophy was noted more commonly in patients with alcohol-induced liver disease. The neuropsychological tests correlated significantly with albumin, prothrombin time, Child-Pugh's score, clinical encephalopathy, and ammonia. T1W signal and cortical atrophy did not correlate with the neuropsychological tests, clinical encephalopathy, ascites, albumin, prothrombin time, ammonia, or Child-Pugh's score. Patients with high T1W signal showed significant correlation with bilirubin (P < .005). This study suggests that globus pallidus signal in T1W images observed in liver disease are not indicators of chronic hepatic encephalopathy as previously assumed.
P J Thuluvath; D Edwin; N C Yue; C deVilliers; S Hochman; A Klein
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  21     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-06     Completed Date:  1995-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  440-2     Citation Subset:  IM    
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
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MeSH Terms
Chronic Disease
Globus Pallidus / pathology*
Hepatic Encephalopathy / complications,  diagnosis*
Liver Cirrhosis / complications,  diagnosis*
Magnetic Resonance Imaging / methods*
Middle Aged
Neuropsychological Tests
Comment In:
Hepatology. 1996 Jul;24(1):282-3   [PMID:  8707277 ]

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