DELAYED ENCEPHALOPATHY AFTER ACUTE CARBON-MONOXIDE INTOXICATION - MR IMAGING FEATURES AND DISTRIBUTION OF CEREBRAL WHITE MATTER LESIONS
DELAYED ENCEPHALOPATHY AFTER ACUTE CARBON-MONOXIDE INTOXICATION - MR IMAGING FEATURES AND DISTRIBUTION OF CEREBRAL WHITE MATTER LESIONS
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DOI：
10.1148/radiology.184.1.1609067
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发表时间：
1992-07-01
期刊：
影响因子：
19.7
通讯作者：
HAN, MC
中科院分区：
文献类型：
--
作者：
CHANG, KH;HAN, MH;HAN, MC
本文回顾了15例急性一氧化碳中毒后迟发性脑病的磁共振图像。暴露于一氧化碳后4-9周，在最初恢复后神经精神症状复发期间获得图像。长时间重复图像显示双侧对称高信号强度脑室周围白质和半瓣膜体（n = 15）。高强度延伸至胼胝体（n = 11）、皮质下U纤维（n = 12）、外（n = 9）和内（n = 7）囊。10例患者在t2加权图像上显示双侧丘脑和壳核弥漫性低强度信号，提示铁沉积。9例患者出现双侧苍白球缺血或坏死。在随访磁共振成像研究的4例患者中，有3例白质病变的范围和信号强度减少，同时临床症状减轻。这些结果表明，迟发性脑病与一氧化碳中毒相关的主要病理特征是脑白质的可逆脱髓鞘过程。
Magnetic resonance (MR) images obtained in 15 patients with delayed encephalopathy after acute carbon monoxide (CO) intoxication were reviewed. Images had been obtained 4-9 weeks after exposure to CO, during the relapse of neuropsychiatric symptoms after initial recovery. Bilateral symmetric confluent high signal intensity in the periventricular white matter and centrum semiovale was seen on long-repetition-time images (n = 15). The high intensity extended into the corpus callosum (n = 11), subcortical U fibers (n = 12), and external (n = 9) and internal (n = 7) capsules. Bilateral diffuse low-intensity signal in the thalamus and putamen on T2-weighted images, suggesting iron deposition, was demonstrated in 10 patients. Bilateral ischemia or necrosis of the globus pallidus was seen in nine patients. In three of four patients with follow-up MR imaging studies, a decrease in extent and signal intensity of white matter lesions accompanied lessening of clinical symptoms. These results suggest that the main pathologic feature of delayed encephalopathy associated with CO intoxication is a reversible demyelinating process of the cerebral white matter.