title: High signal in the adenohypophysis on T1-weighted images presumably due to manganese deposits in patients on long-term parenteral nutrition.
abstract: Hypermanganesaemia is reported in patients on long-term parenteral nutrition. Deposition of manganese, giving high signal on T1-weighted images, may involve the basal ganglia. MRI in nine patients (mean age 51 years, range 31-75 years) on long-term parenteral nutrition (mean duration 30 months, range 6-126 months), demonstrated high signal in the anterior pituitary gland on T1-weighted sagittal and coronal images. The gland appeared normal on T2-weighted images. Signal intensity in the basal ganglia on T1-weighted images was increased in all patients. Endocrine assessment showed no significant abnormality. Neurological examination showed a mild parkinsonian movement disorder in one patient. Hypermanganaesemia was present in all nine (1.3-2.8 micromol/l, mean 1.87 micromol/l). The high signal in the anterior pituitary gland was probably related to deposition of paramagnetic substances, especially manganese.
authors.affiliation: Department of Radiology 2, University Hospital of Strasbourg, Hôpital de Hautepierre, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Dietemann
authors.forename: J M
authors.initials: JM
authors.lastname: Reimund
authors.forename: R L
authors.initials: RL
authors.lastname: Diniz
authors.forename: M
authors.initials: M
authors.lastname: Reis
authors.forename: R
authors.initials: R
authors.lastname: Baumann
authors.forename: C
authors.initials: C
authors.lastname: Neugroschl
authors.forename: S
authors.initials: S
authors.lastname: Von Söhsten
authors.forename: J M
authors.initials: JM
authors.lastname: Warter
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001479:Basal Ganglia / Q000033:anatomy & histology / Q000737:chemistry; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008345:Manganese / Q000032:analysis* / Q000097:blood; D008875:Middle Aged; D010288:Parenteral Nutrition; D010903:Pituitary Gland, Anterior / Q000033:anatomy & histology* / Q000737:chemistry; D012737:Sex Factors
chemical_list: D008345:Manganese