MR Imaging with Diffusion-Weighted Imaging in Acute and Chronic Wernicke Encephalopathy
Matthew L. Whitea,
Yan Zhangb,
Lee G. Andrewc and
Wyatt L. Hadleyb
a Department of Radiology, University of Nebraska College of Medicine, Omaha, NE
b Department of Radiology, University of Iowa College of Medicine, Iowa City, IA
c Department of Ophthalmology, University of Iowa College of Medicine, Iowa City, IA
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FIG 1. Axial FLAIR (A) and diffusion-weighted images (B) from the initial MR imaging examination both demonstrate hyperintensities in the thalami and caudates bilaterally. Axial FLAIR (C) and diffusion-weighted images (D) from the follow-up MR imaging examination 1 year and 10 months later show no abnormal signal intensities in the thalami and caudates bilaterally. Axial FLAIR image (E) shows that there is mild interval increased T2 hyperintense signal intensity in the frontal and parietal white matter.
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FIG 2. Axial FLAIR (A) and diffusion-weighted images (B) from the initial MR imaging examination both demonstrate minimal hyperintensities in the thalami bilaterally (arrows). The hyperintensities are more obvious on the diffusion-weighted image. T2 hyperintensity in the right frontal lobe represents encephalomalacia from a previous injury. Axial FLAIR (C) and diffusion-weighted images (D) from the follow-up MR imaging examination 9 months later show no abnormal signal intensities in the thalami bilaterally. Note the overall volume loss with enlarged sulci and ventricles.
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FIG 3. Axial FLAIR (A) and diffusion-weighted images (B) from the initial MR imaging examination both demonstrate hyperintensities in the thalami bilaterally. The hyperintensities are more obvious on the diffusion-weighted image. Axial FLAIR (C) and diffusion-weighted images (D) from the follow-up MR imaging examination 9 months later show no abnormal signal intensities in the thalami bilaterally. No brain atrophy is found. The abnormal signal intensity in the bilateral front lobes on both the FLAIR and diffusion-weighted images results from the artifact. The follow-up diffusion-weighted image (D) was obtained only using a superoinferior gradient.
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