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Acute carbon monoxide poisoning: diffusion MR imaging findings
1Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey.
Abstract:
During the acute stage of carbon monoxide poisoning, diffusion MR images obtained at b=1000 s/mm2 revealed high signal intensity lesions in the white matter, consistent with restricted diffusion. Low apparent diffusion coefficient values (0.18-0.34 x 10(-3) mm2/s) were noted in the affected white matter regions. Follow-up MR imaging performed 16 days later revealed disappearance of white matter lesions, suggesting that during the acute stage of carbon monoxide poisoning, white matter can be more sensitive than gray matter to ischemia.
Insights
Carbon monoxide poisoning can cause acute white matter damage, visible on diffusion MRI. This white matter damage resolves over time, indicating its sensitivity to ischemia.
Area of Science:
- Neurology
- Radiology
- Toxicology
Background:
- Carbon monoxide (CO) poisoning is a common cause of toxic encephalopathy.
- Diffusion-weighted magnetic resonance imaging (dMRI) is sensitive to changes in water molecule movement within tissues.
Observation:
- Acute CO poisoning demonstrated high signal intensity lesions in white matter on dMRI (b=1000 s/mm2).
- Affected white matter regions exhibited restricted diffusion with low apparent diffusion coefficient (ADC) values (0.18-0.34 x 10(-3) mm2/s).
Findings:
- White matter lesions observed during acute CO poisoning disappeared on follow-up MRI after 16 days.
- These findings suggest that white matter is particularly sensitive to ischemic injury in the acute phase of CO poisoning.
Implications:
- Early detection of white matter injury in CO poisoning is possible with dMRI.
- Understanding the differential vulnerability of white and gray matter to CO-induced ischemia can inform clinical management and prognosis.
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