a Department of Emergency Medicine , Chonnam National University Medical School , Gwangju , South Korea.
b Department of Radiology , Chonnam National University Hospital , Gwangju , South Korea.
Clin Toxicol (Phila). 2018 Mar;56(3):161-169. doi: 10.1080/15563650.2017.1352098. Epub 2017 Jul 28.
This study assessed the results of diffusion-weighted imaging (DWI) at presentation for acute charcoal-burning carbon monoxide (CO) poisoning and investigated whether the initial DWI results can predict long-term neurologic outcomes.
The study included 128 patients who suffered from CO poisoning after burning charcoal and underwent DWI. These patients were divided into two groups based on imaging results: a normal DWI group and an abnormal DWI group. Data regarding clinical courses and long-term neurologic outcomes (persistent severe neurologic sequelae) were collected and compared.
The rate of abnormal DWI findings at presentation was 23.4%, and the most common site of abnormalities was the globus pallidus. All lesions in abnormal DWI had decreased apparent diffusion coefficient (ADC) values. The long-term neurologic state was assessed at a median follow-up of 19.5 months, and the frequency of poor long-term neurologic outcome was significantly higher in the abnormal DWI group (40.0% in the abnormal DWI group vs. 1.0% in the normal DWI group; p < .001). Abnormal DWI (odds ratio [OR]): 31.3, 95% confidence interval [CI]: 2.5-397) and old age (OR 1.1, 95% CI: 1.001-1.13) were independent factors for poor long-term neurologic outcomes, whereas the Glasgow Coma Scale score at presentation (OR: 0.7, 95% CI: 0.6-0.9) was negatively associated with the risk of poor long-term neurologic outcome.
In cases involving CO poisoning due to charcoal burning, DWI at presentation may help predict the long-term neurological outcome after discharge.
本研究评估了急性煤炉燃烧引起的一氧化碳（CO）中毒患者就诊时的弥散加权成像（DWI）结果，并探讨了初始 DWI 结果是否可以预测长期神经预后。
该研究纳入了 128 例因烧炭而发生 CO 中毒的患者，所有患者均行 DWI 检查。根据影像学结果将患者分为两组：DWI 正常组和 DWI 异常组。收集并比较了两组患者的临床病程和长期神经预后（持续性严重神经后遗症）数据。
就诊时 DWI 异常发现率为 23.4%，最常见的异常部位是苍白球。DWI 异常的所有病灶均有表观弥散系数（ADC）值降低。中位随访 19.5 个月后评估长期神经状态，DWI 异常组的长期神经预后不良发生率显著高于 DWI 正常组（DWI 异常组为 40.0%，DWI 正常组为 1.0%；p < .001）。DWI 异常（比值比 [OR]：31.3，95%置信区间 [CI]：2.5-397）和高龄（OR 1.1，95% CI：1.001-1.13）是长期神经预后不良的独立因素，而入院时格拉斯哥昏迷量表评分（OR：0.7，95% CI：0.6-0.9）与长期神经预后不良风险呈负相关。
对于因烧炭导致的 CO 中毒患者，就诊时的 DWI 检查有助于预测出院后的长期神经预后。
