Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease
Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease
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DOI：
10.1017/s0317167100038786
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发表时间：
1996-05-01
影响因子：
3
通讯作者：
Olanow, CW
中科院分区：
文献类型：
--
作者：
Hauser, RA;Zesiewicz, TA;Olanow, CW
背景：慢性肝衰竭与大脑 T1 加权磁共振成像基底神经节的高信号异常相关。这些异常与锰中毒后出现的异常惊人相似，由于饮食中的锰通常由肝脏清除，因此我们推测肝功能障碍可能导致锰超载，并解释了慢性肝病患者的 MRI 异常。方法：我们测量了 11 名活检证实的肝硬化患者和 11 名健康年龄和性别匹配的对照者的血锰浓度，我们还对慢性肝病患者的 MRI 上的 T1 信号异常进行了半定量测量，结果：肝硬化患者的血锰浓度 (20.6 +/- 10.2 mcg/L) 显着高于对照者 (7.2 +/- 2.7，p = .0013)，此外，MRI 上 T1 加权信号高信号的半定量评分与肝硬化患者的血锰浓度相关 (r = .65，p = .029)，结论：这些发现表明，慢性肝病与锰超负荷相关，并表明锰是导致 T1 加权信号高信号的原因 在肝病患者的 MRI 上观察到，已知锰中毒会导致帕金森病和与慢性肝病相似的脑病，因此锰毒性可能会导致肝损伤患者出现这些症状，预防或减少锰超负荷的治疗可能具有临床益处。
Background: Chronic liver failure is associated with high signal abnormalities in the basal ganglia on T1-weighted magnetic resonance imaging of the brain. These abnormalities are strikingly similar to those seen following manganese intoxication, As dietary manganese is normally cleared by the liver, we hypothesize that hepatic dysfunction could lead to manganese overload and account for the MRI abnormalities seen in patients with chronic liver disease. Methods: We measured blood manganese concentrations in eleven patients with biopsy-proven hepatic cirrhosis and eleven healthy age and sex-matched controls, We also performed semi-quantitative measures of T1 signal abnormalities on MRI in the patients with chronic liver disease, Results: Patients with cirrhosis had significantly higher blood manganese concentrations (20.6 +/- 10.2 mcg/L) than controls (7.2 +/- 2.7, p = .0013), In addition, semi-quantitative scores of T1-weighted signal hyperintensity on MRI correlated with blood manganese concentration in patients with cirrhosis (r = .65, p = .029), Conclusions: These findings demonstrate that chronic liver disease is associated with manganese overload and suggest that manganese is responsible for the T1-weighted signal hyperintensity seen on MRI of patients with liver disease, As manganese intoxication is known to cause parkinsonism and an encephalopathy similar to those which occur with chronic liver disease, it is possible that manganese toxicity contributes to the development of these symptoms in liver damaged patients and that therapies which prevent or reduce manganese overload may have clinical benefit.