Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T1 hyperintensity

• Published in: Journal of magnetic resonance imaging 2018-05, Vol.47 (5), p.1342-1349
• Main Authors: Lee, Song, Nam, Yoonho, Jang, Jinhee, Na, Gun Hyung, Kim, Dong Goo, Shin, Na‐Young, Choi, Hyun Seok, Jung, So‐Lyung, Ahn, Kook‐Jin, Kim, Bum‐soo
• Format: Article
• Language: English
• Subjects: Brain; Cirrhosis; Correlation analysis; deep gray matter; Dentate nucleus; Field strength; Globus pallidus; Heavy metals; Image reconstruction; Iron; Liver; Liver cirrhosis; Magnetic permeability; Magnetic resonance imaging; Manganese; Mapping; Metabolism; Neuroimaging; NMR; Nuclear magnetic resonance; pallidal hyperintensity; Patients; Quantitative susceptibility mapping; Substantia grisea
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.25841

BACKGROUND The liver is a central organ for the metabolism of iron and manganese and the places where those metals are commonly deposited overlap in the brain. PURPOSE/HYPOTHESIS To elucidate the relationship between pallidal T1 hyperintensity and iron deposition in the deep gray matter of liver cirrhosis patients using quantitative susceptibility mapping (QSM). STUDY TYPE Retrospective case–control study SUBJECTS: In all, 38 consecutive liver cirrhosis patients who received brain magnetic resonance imaging (MRI) as pretransplant evaluation. FIELD STRENGTH/SEQUENCE QSM was reconstructed from 3D multi‐ or single‐echo phase images at 3T. T1‐weighted images were used for the assessment of pallidal hyperintensity and pallidal index (PI). ASSESSMENT Patients were divided into two groups according to the presence of pallidal hyperintensity by consensus of two radiologists. Susceptibility values were acquired for five deep gray matter structures. STATISTICAL TEST QSM measures were compared between two groups using the t‐test. We also calculated Pearson correlations between QSM measures and PI. RESULTS In all, 26 patients showed pallidal hyperintensity (T1h group) and 12 did not (T1n group). The susceptibility of the globus pallidus (GP) in the T1h group (120.6 ± 38.1 ppb) was significantly lower than that in the T1n group (150.0 ± 35.2, P = 0.030). The susceptibility of the dentate nucleus (DN) in the T1h group (88.1 ± 31.0) was significantly lower than that in the T1n group (125.6 ± 30.6, P = 0.001). Negative correlation between the susceptibility of GP (r = –0.37, P = 0.022) and the PI, and between DN (r = –0.43, P < 0.001) and the PI was found. DATA CONCLUSION Liver cirrhosis patients with pallidal T1 hyperintensity had lower susceptibility values in the GP and DN than those without it. This suggests a possible interaction between iron and manganese in the brains of liver cirrhosis patients. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1342–1349.