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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:1557-1560, October 2002
© 2002 American Society of Neuroradiology

Case Report
BRAIN

³¹Phosphorous and Single Voxel Proton MR Spectroscopy and Diffusion-Weighted Imaging in a Case of Star Fruit Poisoning

Y.L. Chan^a, H.K. Ng^b, C.B. Leung^c and D.K.W. Yeung^d

^a Departments of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
^b Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
^c Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
^d Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong

Address reprint requests to Y.L. Chan, Department of Diagnostic Radiology & Organ Imaging, Prince of Wales Hospital, Shatin, N.T., Hong Kong

Summary: We herein describe the case of a patient with chronic renal failure complicated by star fruit poisoning. T2-weighted and diffusion-weighted MR imaging showed hyperintense lesions at the thalami and right temporo-occipital cortex. Single voxel proton MR spectroscopy revealed elevation of lactate and ³¹phosphorous MR spectroscopy revealed elevation of inorganic phosphate and decrease of phosphocreatine and nucleoside triphosphates. The imaging and metabolic changes indicated energy deprivation, with subsequent cortical necrosis proved at autopsy.