J Korean Neurol Assoc > Volume 20(2); 2002 > Article

Journal of the Korean Neurological Association 2002;20(2): 142-146.

지연성 저산소성 뇌병증에서 확산강조 MRI 소견의 변화

김한영 , 나덕렬 문소영 손영민 정필욱 나동규 이광호

성균관대학교 의과대학 신경과학교실, 진단방사선학과 교실

"A Serial Diffusion-weighted MR Imaging Study in Delayed Postanoxic Encephalopathy"

Hahn-Young Kim

"Departments of Neurology and Diagnostic Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine"

Abstract

"Background : Delayed postanoxic encephalopathy (DPE) is a demyelinating disorder in which cognitive, behavioral and movement deteriorations relapse in a few weeks after a complete recovery from initial hypoxic injury. To our knowledge, there have been no reports describing the temporal change of diffusion-weighted imaging (DWI) findings in DPE. Methods : In a patient with DPE, serial brain MRI including DWI was performed at admission, 1, 3, 5 and 11 months after the onset of DPE. In order to obtain apparent diffusion coefficient (ADC) value of the lesion, we selected the same axial slices of the serial DWI and placed eight regions of interest (ROIs) in the periventricular white matter. Mean ADC values of ROIs and ADC map were serially compared. Results : Compared to normal value, the ADC values of ROIs remained low at admission and one-month follow-up (0.68 0.08 and 0.67 0.08×10-3mm2/s) and then con - tinued to increase on the 3, 5 and 11-month follow-up (0.78 0.05, 0.80 0.05 and 0.87 0.11×10-3mm2/s). Abnormal low signal density in both periventricular white matters on initial ADC map also disappeared slowly. Serial ADC maps revealed continuing diffuse cytotoxic edema over 1 month after the onset of DPE. Conclusions : Delayed cytotoxic edema associated with delayed clinical symptom of DPE might implicate that possible pathogenesis of DPE is apoptosis. DWI including ADC map might be useful to detect apoptotic brain lesion.Key Words : Delayed postanoxic encephalopathy, Apparent diffusion coefficient, Magnetic resonance imaging,"