MRI diagnosis of Wernicke encephalopathy after major surgical operation

Abstract

Objective To analyze MRI imaging features of patients with Wernicke encephalopathy after major surgical operation.Methods Clinical data including cranial MRI features were reviewed on five patients of Wernicke encephalopathy after major surgical operation from Jan 2012 to Nov 2013.Results The clinical features of patients with Wernicke encephalopathy after major surgical operation were noncharacterized and most of them had no specific value for diagnosis except for a definite history of vit B1 insufficiency.MRI imaging showed abnormal signal in the medial thalamus,third ventricle,surrounding area of the aqueduct of midbrain,column of fornix and the dorsal midbrain and pons ; Lesions were showed with long T1 and long T2 signal intensity and high signal intensity on fluid-attenuated inversion recovery (FLAIR),and high signal intensity on DWI(b equals 1 000 s/mm2).ADC value in all lesions increased from [(0.46-0.59) ×10-3 mm2/s] before treatment to [(0.81-1.10) ×10-3 mm2/s] after vit B1 supplement.Conclusions Wernicke encephalopathy has typical MRI imaging presentations.Early diagnosis and timely supplement of vitamin B1 can improve the prognosis. Key words: Wernicke encephalopathy ; Nutrition disorders ; Prognosis