Liu Jing, Zhang Lin, He Bin, Zhuang Jian-Hua, Xu Jin, Huang Li-Yu, Peng Hua
Department of Radiology, Shanghai Dongfang Hospital, Tongji University, PR China.
Department of Neurology, Changzheng Hospital, Second Military Medical University, PR China.
Clin Neurol Neurosurg. 2019 Sep;184:105398. doi: 10.1016/j.clineuro.2019.105398. Epub 2019 Jul 9.
Toxic encephalopathy induced by exposure to 1,2-dichloroethane(1,2-DCE) may result in central nervous system (CNS) abnormalities. The study was to describe the clinical and neuroimaging features in toxic encephalopathy induced by 1, 2-DCE.
The study evaluates six patients with clinical symptoms and neuroimaging who are exposed to 1, 2-DCE, including medical and neurologic examination, CT imaging, proton MR spectroscopy (MRS), Diffusion weighted MR (DW MR) and T1-and T2-weighted MR imaging.
All patients who had been exposed to DCE subsequently had seizures or symptoms of intracranial hypertension,including headache, nausea, and vomiting. CT findings: All lesions appeared as low density and bilateral symmetry. The lesions appeared in white matter of cerebral hemisphere diffusely, bilateral cerebellar dentate nuclei, thalamus and globus pallidus. MRI features: All lesions showed high signal intensity on T2WI. Cerebral sulci swelling and compressed or occluded ventricles were seen on CT and MRI. DW MR images obtained at b = 1000s/mm2 revealed symmetrical high signal intensity changes. The apparent diffusion coefficient (ADC) values of lesions were decreased. MR spectroscopic findings established the spectral patterns: increased choline-containing compounds and decreased N-acetylaspartate.
The clinical symptoms of intracranial hypertension and the features of CT and MR imagings are useful for early diagnosis and prompt treatment in toxic encephalopathy.
接触1,2 - 二氯乙烷（1,2 - DCE）所致的中毒性脑病可能导致中枢神经系统（CNS）异常。本研究旨在描述1,2 - DCE所致中毒性脑病的临床和神经影像学特征。
本研究评估了6例接触1,2 - DCE且有临床症状和神经影像学表现的患者，检查包括医学和神经学检查、CT成像、质子磁共振波谱（MRS）、扩散加权磁共振成像（DW MR）以及T1加权和T2加权磁共振成像。
所有接触DCE的患者随后均出现癫痫发作或颅内高压症状，包括头痛、恶心和呕吐。CT表现：所有病灶均呈低密度且双侧对称。病灶弥漫性出现在大脑半球白质、双侧小脑齿状核、丘脑和苍白球。MRI特征：所有病灶在T2WI上呈高信号强度。CT和MRI可见脑沟增宽以及脑室受压或闭塞。在b = 1000s/mm2时获得的DW MR图像显示对称的高信号强度改变。病灶的表观扩散系数（ADC）值降低。磁共振波谱结果确定了波谱模式：含胆碱化合物增加，N - 乙酰天门冬氨酸减少。
颅内高压的临床症状以及CT和MRI特征有助于中毒性脑病的早期诊断和及时治疗。
