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Acute Carbon Monoxide Poisoning: Diffusion MR Imaging Findings

R. Nuri Senera

a Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey



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  		FIG 1. MR images obtained during the acute stage of carbon monoxide poisoning.

A, Fluid-attenuated inversion recovery image of the region of the basal ganglia is normal.

B, Fluid-attenuated inversion recovery image corresponding to the images shown in Figure 2A and B appears normal.



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  		FIG 2. Diffusion MR images obtained during the acute stage.

A, b = 1000 s/mm2 image reveals prominent high signal intensity in the parietal white matter, consistent with restricted diffusion, hence cytotoxic edema. Subtle involvement of outer cortical regions is noted.

B, ADC map (same section as that shown in A) reveals very low ADC values in the affected white matter (0.25 and 0.28 x 10-3 mm2/s; mean values of pixels 1 and 2), compared with the normal ADC value from unaffected white matter (0.79 x 10-3 mm2/s; mean value of pixel 3).

C, b = 1000 s/mm2 image reveals high signal intensity in the frontal and temporal white matter. Some involvement of the posterior portions of the globi pallidi and of the temporal cortices is noted.

D, ADC map (same section as that shown in C) reveals very low ADC values in the affected white matter regions (0.20 and 0.26 x 10-3 mm2/s; mean values of pixels 1 and 2). Normal ADC values from several regions including the basal ganglia, thalamus, and occipital parenchyma are shown (0.75, 0.77, 0.77, and 0.78 x 10-3 mm2/s; mean values of pixels 3–6).



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  		FIG 3. MR images obtained 16 days later.

A, Fluid-attenuated inversion recovery image corresponding to the image shown in Figure 1A reveals development of prominent high signal intensity lesions in the basal ganglia.

B, Fluid-attenuated inversion recovery image corresponding to the image shown in Figure 1B continues to show no white matter abnormalities.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X