Deniz S, Oppenheim C, Lehéricy S, Sharshar T, Lalam T F, Dormont D, Marsault C
Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris VI University, France.
Neurotoxicology. 2000 Jun;21(3):405-8.
Methanol intoxication is an uncommon clinical problem leading to profound metabolic acidosis with serious neurological deterioration. We describe methanol induced brain lesions on diffusion-weighted MR images and discuss the pathophysiology of these lesions in light of diffusion changes.
Brain imaging was performed in a 32 year-old man in a coma with focal neurological signs. Bilateral putaminal [hyperintensity] was seen on fast spin echo T2-weighted sequences, on Fluid Attenuated Inversion Recovery (FLAIR) and on diffusion weighted images. Decreased ADC values were observed bilaterally in the putamina. In addition, FLAIR images showed diffuse hypersignal in the subarachnoidal space. The patient showed rapid neurological deterioration while blood chemical tests revealed a severe metabolic acidosis and plasma methanol levels of 21 mmol/L. The patient died from hepatic failure thirty six hours after admission.
Although decreased ADC values on diffusion-weighted imaging are commonly associated with arterial ischemic stroke, this pattern can also be observed in the case of putaminal necrosis following methanol ingestion.
甲醇中毒是一个不常见的临床问题，可导致严重的代谢性酸中毒并伴有严重的神经功能恶化。我们描述了甲醇中毒导致的脑病变在扩散加权磁共振成像上的表现，并根据扩散变化讨论这些病变的病理生理学。
对一名32岁昏迷且有局灶性神经体征的男性进行了脑成像检查。在快速自旋回波T2加权序列、液体衰减反转恢复（FLAIR）序列和扩散加权图像上均可见双侧壳核[高信号]。双侧壳核的表观扩散系数（ADC）值降低。此外，FLAIR图像显示蛛网膜下腔弥漫性高信号。患者神经功能迅速恶化，而血液化学检查显示严重代谢性酸中毒，血浆甲醇水平为21 mmol/L。患者入院三十六小时后死于肝功能衰竭。
虽然扩散加权成像上ADC值降低通常与动脉缺血性卒中有关，但在甲醇摄入后发生壳核坏死的情况下也可观察到这种表现。
