MRI IN CHILDREN RECEIVING TOTAL PARENTERAL-NUTRITION

Cranial MRI was obtained in 13 of a group of 57 children receiving lon g-term parenteral nutrition, who were being investigated for hypermang anasaemia, Increased signal intensity on T1-weighted im ages has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in are welding. It has been postulated that these changes are due to deposition of the p aramagnetic trace element manganese. In excess manganese is hepato- an d neurotoxic and we present the correlation of whole blood manganese l evels with imaging findings. The age range of bur patients was 6 month s to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weig hted images, with no abnormality on T2-weighted images. All patients h ad elevated whole blood manganese levels, suggesting that the basis fo r this abnormality is indeed deposition of manganese within the tissue s.