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Simultaneous PET/MRI Imaging During Mouse Cerebral Hypoxia-ischemia
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Diffusion MR imaging of hypoglycemic encephalopathy.

E G Kang1, S J Jeon, S S Choi

  • 1Department of Radiology, Wonkwang University Hospital, Chunbuk, Republic of Korea.

AJNR. American Journal of Neuroradiology
|October 31, 2009
PubMed
Summary

Hepatic encephalopathy (HE) lesions on MRI show specific patterns in the brain, particularly restricted diffusion on DWI. Lesion extent on diffusion-weighted imaging (DWI) can predict HE patient prognosis.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Magnetic Resonance (MR) imaging features of hepatic encephalopathy (HE) require further elucidation.
  • Understanding the precise distribution and diffusion characteristics of HE lesions is crucial for diagnosis and prognosis.

Purpose of the Study:

  • To determine the topographic distribution of HE lesions using MR imaging.
  • To characterize the diffusion-weighted imaging (DWI) findings in patients with HE.

Main Methods:

  • Retrospective analysis of MR imaging in 11 patients with HE.
  • Evaluation of lesion distribution on routine MR imaging.
  • Assessment of DWI signal intensity (SI) and apparent diffusion coefficient (ADC) values, with comparison to noninvolved white matter (WM).

Main Results:

  • Bilateral diffusion-restrictive lesions were observed in the posterior limb of the internal capsule (IC), cerebral cortex, corona radiata (CR), corpus striatum (CS), hippocampus, and basal ganglia (BG).
  • Mean ADC values of lesions were significantly lower (448.82 ± 92.34 x 10⁻⁶ mm²/s) compared to noninvolved subcortical WM (837.72 ± 62.14 x 10⁻⁶ mm²/s) (P < .000).
  • Complete resolution on follow-up DWI was noted in 6 patients; prognosis varied based on lesion extent, with extensive cortical involvement correlating with poorer outcomes.

Conclusions:

  • HE lesions commonly localize to the posterior limb of the IC, cerebral cortex, CR, CS, hippocampus, and BG.
  • DWI findings suggest HE lesions represent reversible cytotoxic edema.
  • The extent of lesion involvement on DWI can predict the prognosis of HE.