PALLIDAL LESIONS IN PATIENTS WITH LIVER-CIRRHOSIS - CLINICAL AND MRI EVALUATION

Fifty patients with liver cirrhosis underwent neurological, psychometr ic, electroencephalographic and biochemical examination as well as cra nial magnetic resonance imaging (MRI) to study the incidence of pallid al lesions in cirrhotics and their correlation to liver function, as w ell as to neurological and mental state. In one patient a histopatholo gical study of the brain was performed. The vast majority of the patie nts with liver cirrhosis (92%) present with bilateral symmetric pallid al hyperintensities in the T1-weighted MR spin echo sequences, while t he T2-weighted images are normal. On the whole there was no correlatio n between the signal intensity of the pallidal lesions and measures of liver function, neurological status or grade of encephalopathy. As co uld be shown in follow-up examinations the signal intensity of the les ions increased with decreasing liver function and decreased with norma lization of liver function after liver transplantation. The substrate of the lesions remains unclear. However, regions which show alteration s in the MRI are histopathologically characterized by the appearance o f Alzheimer-type-II cells.