Esra Akcan1, Sultan Özkurt2, Garip Sahin3, Ahmet Ugur Yalcin3, Baki Adapinar4. 1. Department of Radiology, Eskisehir State Hospital, Eskisehir, Turkey. 2. Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey. dr.s.guvenir@hotmail.com. 3. Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey. 4. Private Acıbadem Eskisehir Hospital, Eskisehir, Turkey.
Abstract
PURPOSE: Various factors can affect blood and tissue levels of trace elements in patients with end-stage renal disease. There are a few studies showing hyperintensity of basal ganglia associated with manganese deposition in hemodialysis (HD) patients. The present study aimed to investigate the intensity changes as markers of manganese deposition in the basal ganglia and to demonstrate their association with blood manganese levels using ICP/MS technique in HD, peritoneal dialysis (PD), and renal transplant patients. METHODS: The study included 20 HD, 20 PD, 20 renal transplant patients, and 20 healthy controls. Blood manganese levels were obtained, and cranial magnetic resonance images were evaluated for basal ganglia hyperintensity. RESULTS: Blood manganese levels were similar across all study groups (p = 0.308), whereas symmetric basal ganglia hyperintensity indicating manganese deposition was detected only in HD patients (p = < 0.001). There was a significant relationship between manganese deposition and duration of dialysis (p = 0.05). CONCLUSION: Imaging findings suggesting manganese deposition in the basal ganglia being present only in HD patients suggest that manganese deposition could be caused by the hemodialysis method itself rather than uremia and renal failure. Further studies are required in this regard, as previous studies have not clearly identified the mechanisms by which hemodialysis causes these changes.
PURPOSE: Various factors can affect blood and tissue levels of trace elements in patients with end-stage renal disease. There are a few studies showing hyperintensity of basal ganglia associated with manganese deposition in hemodialysis (HD) patients. The present study aimed to investigate the intensity changes as markers of manganese deposition in the basal ganglia and to demonstrate their association with blood manganese levels using ICP/MS technique in HD, peritoneal dialysis (PD), and renal transplant patients. METHODS: The study included 20 HD, 20 PD, 20 renal transplant patients, and 20 healthy controls. Blood manganese levels were obtained, and cranial magnetic resonance images were evaluated for basal ganglia hyperintensity. RESULTS: Blood manganese levels were similar across all study groups (p = 0.308), whereas symmetric basal ganglia hyperintensity indicating manganese deposition was detected only in HDpatients (p = < 0.001). There was a significant relationship between manganese deposition and duration of dialysis (p = 0.05). CONCLUSION: Imaging findings suggesting manganese deposition in the basal ganglia being present only in HDpatients suggest that manganese deposition could be caused by the hemodialysis method itself rather than uremia and renal failure. Further studies are required in this regard, as previous studies have not clearly identified the mechanisms by which hemodialysis causes these changes.
Authors: J L Dietemann; J M Reimund; R L Diniz; M Reis; R Baumann; C Neugroschl; S Von Söhsten; J M Warter Journal: Neuroradiology Date: 1998-12 Impact factor: 2.804