Temporal parenteral nutrition in children causing t1 shortening in the anterior pituitary gland and globus pallidus.

Patients receiving long-term parenteral nutrition (PN) with trace elements (TE) may exhibit T-1 shortening in the anterior pituitary gland and basal ganglia. The purposes of this study were to clarify at what time or from what site the signal change begins in children. Retrospective analysis of magnetic resonance imaging results was performed for 10 pediatric patients aged from 1 to 16 years receiving temporal PN, eight of which received PN with TE for less than two months, and 13 patients with headache or seizures as age-matched controls. Axial and sagittal T-1-weighted images were obtained to analyze the T-1 shortening in the anterior pituitary gland and globus pallidus. All eight patients receiving PN with TE exhibited T-1 shortening in the anterior pituitary gland (six patients) and/or globus pallidus (five patients). No T-1 shortening was observed in the other two patients without TE, or the 13 age-matched controls. Therefore, the signal change may be associated with TE administration, and begins markedly earlier than previously reported. We discussed the possibility that manganese (Mn) caused the signal change, and proposed that the administration of a lower dose of Mn is recommended, even in the case of temporal PN, to prevent possible Mn toxicity toward both the brain and liver.