Conventional and diffusion-weighted MRI in the evaluation of methanol poisoning

A Server1, K E Hovda, P Hj Nakstad

  • 1Departments of Neuroradiology, Division of Radiology, and Medicine, Ullevål University Hospital, Oslo, Norway. Andres.ServerAllonso@ulleval.no

Insights

Methanol poisoning can cause cerebral lesions, particularly in the putamina. Magnetic resonance imaging (MRI) revealed cytotoxic edema and post-necrotic changes in two patients, highlighting the neurotoxic effects of methanol.

Area of Science:

  • Neurology
  • Radiology
  • Toxicology

Background:

  • Methanol poisoning is a serious condition that can lead to severe neurological deficits.
  • Magnetic resonance imaging (MRI) is a crucial tool for diagnosing and understanding the extent of brain damage.

Observation:

  • Two cases of methanol poisoning were examined using conventional MRI.
  • Diffusion-weighted MRI (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences were utilized.

Findings:

  • Conventional MRI revealed symmetrical, bilateral increased signals in the lentiform nuclei (predominantly putamina) extending to surrounding white matter in one patient.
  • Diffusion-weighted MRI (DWI) indicated decreased diffusion in these areas, suggesting cytotoxic edema.
  • The second patient exhibited putaminal hyperintensity on FLAIR and T2-weighted images, indicative of post-necrotic changes.

Implications:

  • These findings underscore the characteristic neuroimaging patterns of methanol-induced brain injury.
  • MRI, including DWI, is valuable for early detection and characterization of cerebral lesions in methanol poisoning.
  • Understanding these patterns aids in clinical management and prognosis assessment for methanol-exposed individuals.