Evaluation of the basal ganglia in patients with hepatocellular carcinoma using magnetization transfer

Conventional T1-weighted spin echo (T1 WSE) and calculated magnetization transfer ratios (MTRs) images of brain were obtained in 22 patients with hepatocellular carcinoma (HCC) and phantoms containing either of gelatin or MnCl2. The former phantoms (Ge-P) contained gelatin of various contents. The latter phantoms (Mn-P) had various MnCl2 concentrations in 20% gelatin gel. MT was achieved with a standard three-dimensional sequence performed with spoiled gradient recalled acquisition in steady state (SPGR, GE Medical Systems) with the MT pulse. MTRs were calculated with and without the MT pulse applied. In phantom study, the MTRs of the Ge-P and Mn-P showed different characteristics. In the Ge-P, the MTRs were increased with increasing gelatin contents, but in the Mn-P, the MTRs were decreased with increasing MnCl2 concentrations. In clinical study, signal intensity of basal ganglia were measured and MTRs calculated. We examined the relationship between MTRs and liver function parameters (ChE, PT, ICGR15). The MTRs of patients with HCC were decreased with the degree of liver dysfunction. The change of MTRs in patients with HCC showed the same change of MTRs in Mn-P. This study suggests that high intensity of globus pallidus on T1 WSE were due to paramagnetic materials. MTRs might be a new indicator for assessment of liver dysfunction. (author)