High pallidal T1 signal is rarely observed in obstructive jaundice, but is frequently observed in liver cirrhosis.
Although high signal intensities in the globus pallidus are frequently observed in T1-weighted magnetic resonance images (MRI) of patients with liver cirrhosis, it is unclear whether these increases are due to portal-systemic shunt or obstruction of biliary excretion. We therefore studied pallidal signals in 18 cancer patients with bile duct obstruction and marked jaundice (>10 mg/dl). Patients who had fever, leukocytosis or liver cirrhosis were excluded to ensure that jaundice was due to bile duct obstruction. All patients showed a dilated intrahepatic duct on computed tomography (CT) scan. A high pallidal signal was observed in one of 18 biliary obstructive patients whereas high signals were highly prevalent in liver cirrhosis. A portal-systemic shunt rather than an obstruction of biliary excretion may be responsible for the increased blood manganese concentrations and pallidal T1 signals in chronic liver diseases.
Bang
Sung-Jo
SJ
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, South Korea.
Choi
Seong Hoon
SH
Park
Neung Hwa
NH
Shin
Jung Woo
JW
Choy
Nari
N
Kim
Suk Hwan
SH
Kim
Yangho
Y
D000368:Aged; D004067:Digestive System Neoplasms / Q000150:complications; D005260:Female; D005917:Globus Pallidus / Q000378:metabolism*; D006801:Humans; D041781:Jaundice, Obstructive / Q000097:blood* / Q000209:etiology; D008103:Liver Cirrhosis / Q000097:blood*; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008345:Manganese / Q000097:blood; D008875:Middle Aged
D008345:Manganese