Diffusion-Weighted MR Imaging in Early Diagnosis and Prognosis of Hypoglycemia
L. Loa,
C.H.A. Tana,
T. Umapathib and
C.C. Lima,c
a Departments of Neuroradiology, National University of Sinagpore, Singapore
b Neurology, National Neuroscience Institute, National University of Sinagpore, Singapore
c Department of Diagnostic Radiology, National University of Sinagpore, Singapore
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Fig 1. Case 1, a 65-year-old man in a diabetic coma with seizures.
A, Fast spin-echo fluid attenuated inversion recovery (9000 milliseconds/110 milliseconds effective/2200 milliseconds [TR/TE/TI]) MR image shows bilateral hyperintensity of the cortex over the temporal and occipital lobes.
B and C, Diffusion-weighted (10000/105, b value 1000 seconds/mm2) MR images showing corresponding hyperintensity in the cortex.
D and E, ADC maps at the same levels as B and C show decreased ADC in these lesions (618 x 10–3 mm2/s) compared with normal white matter (819 x 10–3 mm2/s).
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Fig 2. Case 2, a 69-year-old diabetic man with atrial fibrillation who suddenly became unresponsive.
A, T2-weighted (3000/80 effective) MR image shows subtle increased intensity in the splenium of the corpus callosum (compared with the genu), posterior limbs of the internal capsules, and thalami bilaterally.
B, Corresponding diffusion-weighted (4200/95, b value 1000 seconds/mm2) MR image shows bilaterally symmetrical hyperintensities in the posterior limbs of the internal capsules and the splenium of the corpus callosum.
C, ADC map corresponding to B shows decreased ADC of the splenium of the corpus callosum (485 x 10–3 mm2/s) compared with the genu (890 x 10–3 mm2/s)
D, DW MR image 12 hours later shows complete normalization of previously noted lesions.
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