Question 2587
{"accessible":false,"alternatives":[{"id":12699,"text":"adrenal glands"},{"id":12695,"text":"kidney"},{"id":12696,"text":"liver"},{"id":12697,"text":"pancreas"},{"id":12698,"text":"thyroid gland"}],"archived":false,"correctAlternativeId":12696,"explanation":"\u003cp\u003eIntrinsic T1 hyperintensity of bilateral globi pallidi usually reflects deposition of \u003ca href=\"/articles/manganese\" title=\"Manganese\"\u003emanganese\u003c/a\u003e in patients with hepatic dysfunction, such as \u003ca href=\"/articles/cirrhosis\" title=\"Cirrhosis\"\u003ecirrhosis\u003c/a\u003e with or without portosystemic shunting, \u003ca href=\"/articles/kernicterus\" title=\"Chronic bilirubin encephalopathy\"\u003echronic bilirubin encephalopathy\u003c/a\u003e (kernicterus) in neonates, or arteriovenous malformation (such as in \u003ca href=\"/articles/hereditary-haemorrhagic-telangiectasia\" title=\"Hereditary hemorrhagic telangiectasia\"\u003ehereditary hemorrhagic telangiectasia\u003c/a\u003e). Manganese has shortens T1 relaxation time. The differential for globi pallidi manganese deposition includes \u003ca href=\"/articles/manganism\" title=\"Manganism\"\u003emanganism\u003c/a\u003e in occupational exposures, genetic \u003ca href=\"/articles/hypermanganesemia%20with%20dystonia\" title=\"hypermanganesemia with dystonia\"\u003ehypermanganesemia with dystonia\u003c/a\u003e, and \u003ca href=\"/articles/hyperalimentation\" title=\"hyperalimentation\"\u003ehyperalimentation\u003c/a\u003e (total parenteral nutrition). T1 shortening in the globi pallidi can also be caused by \u003ca href=\"/articles/gadolinium%20deposition\" title=\"gadolinium deposition\"\u003egadolinium deposition\u003c/a\u003e (due to chronic repeated administration of gadolinium-based contrast agents), but there is usually also deposition in the \u003ca href=\"/articles/dentate-nucleus\" title=\"Dentate nuclei\"\u003edentate nuclei\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eKidney disease can lead to \u003ca href=\"/articles/uraemic-encephalopathy\" title=\"Uremic encephalopathy\"\u003euremic encephalopathy\u003c/a\u003e, which can affect the basal ganglia among other structures with T2 hyperintensity but not T1 hyperintensity.\u003c/p\u003e\u003cp\u003ePancreatic disease, specifically diabetes mellitus, can lead to \u003ca href=\"/articles/non-ketotic-hyperglycaemic-hemichorea\" title=\"Non-ketotic hyperglycemic hemichorea (NHH)\"\u003ehyperglycemic, hyperosmolar, nonketotic state\u003c/a\u003e, which can appear as T1 hyperintensity of the \u003ca href=\"/articles/striatum-1\" title=\"Striatum\"\u003estriatum\u003c/a\u003e usually uniaterally, rather than the globi pallidi bilaterally.\u003c/p\u003e\u003cp\u003eThyroid and adrenal disease does not typically have brain imaging manifestations (except when related to pituitary or hypothalamic disease).\u003c/p\u003e","id":2587,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2587","nextQuestionPath":null,"relatedArticles":[{"id":37902,"title":"Uremic encephalopathy","link":"/articles/uraemic-encephalopathy?lang=us"},{"id":45917,"title":"Acquired hepatocerebral degeneration","link":"/articles/acquired-hepatocerebral-degeneration?lang=us"},{"id":21924,"title":"Non-ketotic hyperglycemic hemichorea","link":"/articles/non-ketotic-hyperglycaemic-hemichorea?lang=us"}],"alsoUsedIn":[{"id":1397,"kind":"RestrictedPage","title":"Page 1397 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/1397"},{"id":2238,"kind":"Course","title":"Toxic \u0026 Metabolic Brain Disorders in Adults - page 2238","link":"https://radiopaedia.org/courses/toxic-and-metabolic-brain-disorders/pages/2238"},{"id":2238,"kind":"Course","title":"Toxic \u0026 Metabolic Brain Disorders in Adults Peer Review - page 2238","link":"https://radiopaedia.org/courses/toxic-and-metabolic-brain-disorders-peer-review/pages/2238"}],"stem":"\u003cp\u003eIntrinsic T1 hyperintensity of the bilateral globi pallidi most likely reflects dysfunction of what organ?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2587"}],"attemptsPercentages":[{"alternativeId":"12697","percentage":3},{"alternativeId":"12698","percentage":2},{"alternativeId":"12696","percentage":87},{"alternativeId":"12695","percentage":7},{"alternativeId":"12699","percentage":1}],"promptToLogin":false,"questionManager":false,"articleId":"basal-ganglia-t1-hyperintensity"}