Abstract
Objective To study the imaging of central pentine myelinolysis (CPM) and extrapontine myelinolysis(EPM) after liver transplantation and value of DWI. Methods Eight patients after liver transplantation with CPM and EPM were included in our study, 4 cases of female and 4 cases of male.MR examinations were performed on Philips 1.5 T MRI system. The sequences included SE T1 WI, FSE T2Wl,axial SE-EPI DWI,TR/TE 6225/118.7 ms, ETL 128, FLIP 90°, thickness 5 nun, matrix 128 ×128,b=1000 mm2/s. Results Four of B type hepatitis and cirrhosis and 1 case combined with hepatic carcinoma, 1 of C type hepatitis with cirrhosis from schistosome,2 of C type hepatitis and cirrhosis, 1 of cholangiogenic cirrhosis. MR demonstrated prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem sparing of the corticospinal tract and peripontine tissue. The lesion manifested high signal intensity both on DWI and ADC map indicating T2 effect and vasogenic edema. Follow up MR in 2 cases 2 months later showed more prolongation of T1 and T2 than the first time and the lesion manifested iso-intensity signal on DWI and high signal intensity on ADC map suggesting increased diffusivity. Abnormal signal intensities were detected on the bilateral caudate head, globus pallidus, putamen and cerebral cortex in 3 cases. Conclusion CPM should be considered when prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem, sparing of the corticospinal tract and peripontine tissue was detected for patients of pest-transplantation. When combined with other area abnormality, EPM and CPM should be considered. DWI can early and sensitively show the lesion. Key words: Myelinolysis,central pentine; Diffusion magnetic resonance imaging
Published Version
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