Globus pallidus magnetization transfer ratio, t1 and t 2 in primary biliary cirrhosis: Relationship with disease stage and age

Purpose: To determine whether the magnetization transfer ratio (MTR) of the globus pallidus (GP) in patients with primary biliary cirrhosis (PBC) correlates with age, disease stage, and fatigue, using T1 and T 2 mapping to determine whether the mechanism of change is consistent with manganese deposition in the GP as suggested by previous reports. Materials and Methods: In all, 30 early-stage PBC patients, four end-stage PBC patients, and 14 female controls were recruited to age-matched groups. MTR, T1 and T2 measurements were performed. A bilateral region of interest (ROI)-based analysis was used to calculate GP MTR, T1, and T2 values. These were correlated with age, disease status, and fatigue. Results: MTR measurements showed a significant, negative correlation with age for controls and early-stage PBC patients, a positive correlation with T2, and no correlation with T1. Only GP T2 is significantly lower in early-stage PBC patients than controls, while end-stage patients demonstrated a simultaneous reduction in T1 and MTR, consistent with GP manganese deposition. Conclusion: MTR measurements correlate with age in both early-stage patient and control groups, but are not associated with manganese deposition or fatigue severity: only the end-stage disease group shows changes in MTR, T1,T2 that are consistent with manganese deposition. © 2009 Wiley-Liss, Inc.