title: Magnetic resonance images of the globus pallidus in patients with idiopathic portal hypertension: a quantitative analysis of the relationship between signal intensity and the grade of portosystemic shunt.
abstract: OBJECTIVE
  To elucidate a quantitative relationship between hyperintensity of the globus pallidus on T1-weighted magnetic resonance images (MRI) and portosystemic shunt (PSS) in portal hypertension.
  
  
  METHODS
  Fifteen patients with idiopathic portal hypertension (IPH) and 44 patients with liver cirrhosis (LC) underwent brain MRI to asses signal intensity at the globus pallidus and Doppler sonography to examine the blood flow volume of PSS. Blood manganese (Mn) levels were examined in 36 patients and neuropsychological tests were performed in 15 patients without overt hepatic encephalopathy.
  
  
  RESULTS
  Pallidal hyperintensity on MRI was more prominent in patients with IPH than in patients with LC. There was no correlation between MRI pallidal hyperintensity and the severity of liver dysfunction or hepatic encephalopathy. The grade of hyperintensity correlated well with the grade of PSS. The correlation was stronger in patients with IPH than in patients with LC. The plasma ammonia level and whole blood Mn level significantly correlated with MRI pallidal hyperintensity, but blood Mn level showed a stronger correlation than plasma ammonia.
  
  
  CONCLUSIONS
  Hyperintensity of the globus pallidus on T1-weighted MRI correlated with the development of PSS independent of liver cell function. This brain image should be an index of the grade of PSS rather than a landmark of chronic liver failure.
authors.affiliation: Department of Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. fukuzawa@kvp.biglobe.ne.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fukuzawa
authors.forename: Shoichi
authors.initials: S
authors.lastname: Matsutani
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Taro
authors.initials: T
authors.lastname: Akiike
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
mesh_terms: D005917:Globus Pallidus / Q000473:pathology*; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011170:Portasystemic Shunt, Surgical