In patients with hepatic cirrhosis, the globus pallidus and putamen show high intensity on T1-weighted MRI. While the causes of this high signal have been thought to include paramagnetic substances, especially manganese, no evidence for this has been presented. Autopsy in four cases of hepatic cirrhosis permitted measurement of metal concentrations in brain and histopathological examination. In three cases the globus pallidus showed high intensity on T1-weighted images. Mean manganese concentrations in globus pallidus, putamen and frontal white matter were 3.03 +/- 0.38, 2.12 +/- 0.37, and 1.38 +/- 0.24 (micrograms/g wet weight), respectively, being approximately four- to almost ten-fold the normal values. Copper concentrations in globus pallidus and putamen were also high, 50% more than normal. Calcium, iron, zinc and magnesium concentrations were all normal. The fourth case showed no abnormal intensity in the basal ganglia and brain metal concentrations were all normal. Histopathologically, cases with showing high signal remarkable atrophy, necrosis, and deciduation of nerve cells and proliferation of glial cells and microglia in globus pallidus.. These findings were similar to those in chronic manganese poisoning. On T1-weighted images, copper deposition shows no abnormal intensity. It is therefore inferred that deposition of highly concentrations of manganese may caused high signal on T1-weighted images and nerve cell death in the globus pallidus.
To study the morphology of the normal and inflamed bladder wall, the findings of magnetic resonance imaging and histopathologic examination of 13 in vitro specimens were correlated. Normal bladder wall appeared as a band of intermediate signal intensity on T1-weighted images and as bands of low (inner) and intermediate (outer) signal intensity on T2-weighted images. Inflamed bladder walls demonstrated two additional inner bands of intermediate (inner) and high (innermost) signal intensity on T1-weighted images and high (inner) and low (innermost) signal intensity on T2-weighted images. The mean histopathologic percentages of muscle bundles in inner and outer bands that appeared on T2-weighted images were 92.5% +/- 4.9 and 78.3% +/- 8.2, respectively. The authors conclude that the total thickness of the two bands of differing intensity that appeared on the T2-weighted images of the normal bladder wall correlated well morphometrically with the muscle layers in the histopathologic specimens, and that the different signal intensities in the muscle layer represent a compact inner and looser outer arrangement of smooth muscle bundles.
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