Neuroimagem na degeneração hepatocerebral induzida por hemocromatose

Werneck, Antonio Luiz dos Santos; Gdalevici, Clarice; Fonseca, Rosa Isabel

doi:10.1590/S0004-282X1997000400019

Resumos

São demonstradas alterações transitórias bipalidais caracterizadas por hiperintensidade na sequência T1 da ressonância nuclear magnética, que ocorreram em um paciente com degeneração hepatocerebral adquirida provocada por hemocromatose. Em função de acrescentar-se a este sinal a visibilização de imagem de hiperintensidade bitalâmica na seqüência T2, discute-se a hipótese destes sinais serem unicamente secundários à degeneração hepatocerebral ou, ainda, se teriam sido também originados pela própria hemocromatose.

degeneração hepatocerebral; hemocromatose; ressonância magnética

Transitory changes are shown through T1 - weighted MRI bipallidal hyperintensity in a patient with acquired hepatocerebral degeneration induced by hemochromatosis. In addition we discuss about the possibility of this image associated with thalamic hyperintensity on T2 - weighted also seen in this case, was just secondary to hepatocerebral degeneration, or if they could be caused by hemochromatosis itself.

hepatocerebral degeneration; hemochromatosis; magnetic resonance

Neuroimagem na degeneração hepatocerebral induzida por hemocromatose

Neuroimage findings in hepatocerebral degeneration induced by hemochromatosis

Antonio Luiz dos Santos Werneck^I; Clarice Gdalevici^II; Rosa Isabel Fonseca^II

^IServiço de Neurologia do Hospital Central do IASERJ (Instituto de Assistência aos Servidores do Estado do Rio de Janeiro), Rio de Janeiro: Serviço de Neurologia

^IIServiço de Neurologia do Hospital Central do IASERJ (Instituto de Assistência aos Servidores do Estado do Rio de Janeiro), Rio de Janeiro: Serviço de Clínica Médica

RESUMO

São demonstradas alterações transitórias bipalidais caracterizadas por hiperintensidade na sequência T1 da ressonância nuclear magnética, que ocorreram em um paciente com degeneração hepatocerebral adquirida provocada por hemocromatose. Em função de acrescentar-se a este sinal a visibilização de imagem de hiperintensidade bitalâmica na seqüência T2, discute-se a hipótese destes sinais serem unicamente secundários à degeneração hepatocerebral ou, ainda, se teriam sido também originados pela própria hemocromatose.

Palavras-chave: degeneração hepatocerebral, hemocromatose, ressonância magnética.

ABSTRACT

Transitory changes are shown through T1 - weighted MRI bipallidal hyperintensity in a patient with acquired hepatocerebral degeneration induced by hemochromatosis. In addition we discuss about the possibility of this image associated with thalamic hyperintensity on T2 - weighted also seen in this case, was just secondary to hepatocerebral degeneration, or if they could be caused by hemochromatosis itself.

Key-words: hepatocerebral degeneration, hemochromatosis, magnetic resonance

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 26-junho-1997.

Dr. Antonio Luiz dos Santos Wemeck Neto - Rua João de Barros 137 / 601 - 22441-100 Rio de Janeiro RJ - Brasil.

1. Brunberg JA, Kanal E, Hirch W, Van Thiel DH. Chronic acquired hepatic failure: MR imaging of the brain at 1.5 T. AJNR 1991;12:909-914.
2. Finlayson MH, Potvin M, Hinchey EJ, Goresky CA. Cerebral ultrastructure changes in acute hepatic coma. J Neuropathol Exp Neurol 1978;37:612.
3. Kretzchmar HA, DeArmond, Forno LA. Measurement of GFAP in hepatic encephalopathy in ELISA and transblot. J Neuropathol Exp Neurol 1985;44:459-471.
4. Kusilevsky J, Pujol J, Junqué C, Deus J, Balanzó J, Capdevila A. MRI pallidal hyperintensity and brain atrophy in cirrhotic patients: two different MRI pattterns of clinical deterioraton? Neurology 1993;43:2570-2573.
5. Inoue E, Hori S, Narumi Y, Fujita M, Kuriyama K, KadotaT, Kuroda C. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images. Radiology 1991;179:957-959.
6. Jog MS, Lang AE. Chronic acquired hepatocerebral degeneration: case reports and new insights. Mov Disord 1995; 10:714-710.
7. Kusilevsky J, Pujol J, Balanzó J, Junqué C, Deus J, Capdevila A, Villanueva C. Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patients: clinical correlations. Hepatology 1992;16:1382-1387.
8. Mirowitz S A, Westrich TJ. Basal ganglial signal intensity alterations: reversal after discontinuations of parenteral manganese administration. Radiology 1992;185:535-536.
9. Olanow CW. Magnetic resonance in Parkinsonism. Neurologic Clinics Philadelphia: W.B. Saunders, 1992;10:405-421.
10. Pujol A, Graus F, Peri J, Mercader JM, Rimola A. Hyperintensity in the globus pallidus on Tl - weighted and inversion -recovery MRI: a possible marker of advance liver disease. Neurology 1991,41:1526-1527.
11. Pujol A, Pujol J, Graus F, Rimola A, Peri J, Mercader JM, Garcia-Pagan JC, Bosch J, Rodes J, Tolosa E. Hyperintensite globus pallidus on Tl - weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 1993;43:65-69.
12. Sethi KD, Adams RJ, Loring DW, El Gammal T. Hallervorden-Spatz syndrome: clinical and resonance imaging correlations. Ann Neurol 1988;24:692-694.
13. Victor M, Adams RD, Cole M. The acquired (non-Wilsonian) type of chronic hepatocerebral degeneration. Medicine 1965:44:345.

Datas de Publicação

Publicação nesta coleção
18 Out 2010
Data do Fascículo
Set 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Brunberg JA, Kanal E, Hirch W, Van Thiel DH. Chronic acquired hepatic failure: MR imaging of the brain at 1.5 T. AJNR 1991;12:909-914.

[2] 2. Finlayson MH, Potvin M, Hinchey EJ, Goresky CA. Cerebral ultrastructure changes in acute hepatic coma. J Neuropathol Exp Neurol 1978;37:612.

[3] 3. Kretzchmar HA, DeArmond, Forno LA. Measurement of GFAP in hepatic encephalopathy in ELISA and transblot. J Neuropathol Exp Neurol 1985;44:459-471.

[4] 4. Kusilevsky J, Pujol J, Junqué C, Deus J, Balanzó J, Capdevila A. MRI pallidal hyperintensity and brain atrophy in cirrhotic patients: two different MRI pattterns of clinical deterioraton? Neurology 1993;43:2570-2573.

[5] 5. Inoue E, Hori S, Narumi Y, Fujita M, Kuriyama K, KadotaT, Kuroda C. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images. Radiology 1991;179:957-959.

[6] 6. Jog MS, Lang AE. Chronic acquired hepatocerebral degeneration: case reports and new insights. Mov Disord 1995; 10:714-710.

[7] 7. Kusilevsky J, Pujol J, Balanzó J, Junqué C, Deus J, Capdevila A, Villanueva C. Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patients: clinical correlations. Hepatology 1992;16:1382-1387.

[8] 8. Mirowitz S A, Westrich TJ. Basal ganglial signal intensity alterations: reversal after discontinuations of parenteral manganese administration. Radiology 1992;185:535-536.

[9] 9. Olanow CW. Magnetic resonance in Parkinsonism. Neurologic Clinics Philadelphia: W.B. Saunders, 1992;10:405-421.

[10] 10. Pujol A, Graus F, Peri J, Mercader JM, Rimola A. Hyperintensity in the globus pallidus on Tl - weighted and inversion -recovery MRI: a possible marker of advance liver disease. Neurology 1991,41:1526-1527.

[11] 11. Pujol A, Pujol J, Graus F, Rimola A, Peri J, Mercader JM, Garcia-Pagan JC, Bosch J, Rodes J, Tolosa E. Hyperintensite globus pallidus on Tl - weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 1993;43:65-69.

[12] 12. Sethi KD, Adams RJ, Loring DW, El Gammal T. Hallervorden-Spatz syndrome: clinical and resonance imaging correlations. Ann Neurol 1988;24:692-694.

[13] 13. Victor M, Adams RD, Cole M. The acquired (non-Wilsonian) type of chronic hepatocerebral degeneration. Medicine 1965:44:345.