Abstract
The aim of this article is to review how MR imaging and associated imaging modalities provide clinicopathologic information on brain damage after carbon monoxide poisoning. Initially, many authors documented typical findings of conventional MR imaging in the gray matter structures such as the globus pallidus and in various regions of cerebral white matter. The focus of investigation has since shifted to observation of cerebral white matter areas that are more frequently detected on MR imaging and are more responsible for chronic symptoms than the gray matter. DWI has dramatically contributed to the ability to quantitatively assess cerebral white matter damage. Subsequently, DTI has enabled more sensitive evaluation than DWI and can demonstrate progressive pathologic changes in the early stage, allowing prediction of chronic conditions. In addition, MR spectroscopy reveals changes in metabolite levels, offering quantitative clinicopathologic information on brain damage after carbon monoxide poisoning.
Highlights
CWM damage can be observed in DNS than before DNS (Fig 2A, -B).[31,46,49]. These findings indicate various regions other than the centrum semiovale and periven- a process of progressive demyelination while DNS develops
In ent with chronic persistent symptoms or DNS.[58]. These reports cases of DNS, ADC after the occurrence of sequelae was lower than suggest that FA in DTI must be able to sensitively and quantitabefore that, and low ADC remained for another 1–2 months.[26,40] tively indicate the extent of demyelination after CO poisoning. These findings suggest progressive de- and, in particular, could demonstrate progressive damage leading myelination with cytotoxic edema
Suggesting a reduction in the directionality of water molecule dif- most previous studies regarding findings of MR spectroscopy in fusion because of demyelination, when DTI was performed in the patients with CO poisoning were only case reports and differences subacute or chronic phases after the appearance of DNS.[49,54,55,56] existed in the regions used for placement of the voxel of interest in
Summary
Deposit foci suggesting hemorrhagic infarctions or iron extrava- weighted imaging are more widespread after the appearance of sation after CO poisoning.[41,42] CWM damage can be observed in DNS than before DNS (Fig 2A, -B).[31,46,49] These findings indicate various regions other than the centrum semiovale and periven- a process of progressive demyelination while DNS develops.
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