• Song Lee, Yoonho Nam, Jinhee Jang, Gun Hyung Na, Dong Goo Kim, Na-Young Shin, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn, and Bum-Soo Kim.
• Department of Radiology, Seoul St. Mary's Hospital, School of Medicine, Catholic University of Korea, Seoul, Korea.
• J Magn Reson Imaging. 2018 May 1; 47 (5): 1342-1349.

BackgroundThe 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/HypothesisTo 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 TypeRetrospective case-control study SUBJECTS: In all, 38 consecutive liver cirrhosis patients who received brain magnetic resonance imaging (MRI) as pretransplant evaluation.Field Strength/SequenceQSM 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).AssessmentPatients 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 TestQSM measures were compared between two groups using the t-test. We also calculated Pearson correlations between QSM measures and PI.ResultsIn all, 26 patients showed pallidal hyperintensity (T1 h group) and 12 did not (T1 n group). The susceptibility of the globus pallidus (GP) in the T1 h group (120.6 ± 38.1 ppb) was significantly lower than that in the T1 n group (150.0 ± 35.2, P = 0.030). The susceptibility of the dentate nucleus (DN) in the T1 h group (88.1 ± 31.0) was significantly lower than that in the T1 n 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 ConclusionLiver 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 Evidence3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1342-1349.© 2017 International Society for Magnetic Resonance in Medicine.

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