Bilateral basal ganglia T1 hyperintensity

Left image shows normal T1 signal intensity of Globus Pallidus, where as
right T1 axial image in a 54yr old male with known chronic liver disease
 shows bilateral globus pallidus T1 hyperintensity.

 

Right image: Another CLD patient with bilateral T1 hyperintensity of Globus Pallidus.

Common causes of bilateral T1 hyperintense basal ganglia include:
1. Physiologic calcification.
2. NF-1
3. Hepatic Encephalopathy.
4. Hyperalimentation (Patients undergoing parenteral feeding).

Less common causes:
1.HIE (Term HIE, Hypoxic cerebral infarction).
2. CO poisoning.
3. Kernicterus.
4. Wilson's Disease.

Rarely thyroid / parathyroid hormonal imbalances, hypoglycemia, Fahr's disease, Hallervorden-Spatz syndrome, JE, Congenital HIV etc. also may cause T1 hyperintensity of the basal ganglia.

In chronic liver disease / cirrhotic patients there is symmetrical T1 hyperintensity in Globus Pallidus and Substantia Nigra.


References:
1. Expert-DDx Brain.