Bentahar Amine, Bellamlih Habib, Chafi Khalil, Salek Monsif, Belabbes Soufiane, Zinoun Brahim, Africha Taoufik
Radiology Department, Moulay Ismail Military Hospital, Meknes, 50000, Morocco.
Department of Radiology, Sidi Mohamed Ben Abdellah University, Fez, 30000, Morocco.
BJR Case Rep. 2024 Sep 9;10(5):uaae034. doi: 10.1093/bjrcr/uaae034. eCollection 2024 Sep.
Nonketotic hyperglycaemia (NKH) is a metabolic disorder typically observed in individuals with inadequately managed or undiagnosed diabetes mellitus (DM). Seizures are a common clinical presentation in NKH, and they tend to respond better to glucose correction than anticonvulsant therapy. MRI scans may reveal both subcortical T2/fluid-attenuated inversion recovery (FLAIR) imaging hypointensity and cortical changes, including cortical grey matter T2/FLAIR imaging hyperintensity and cortical or leptomeningeal enhancement, although cortical abnormalities are less frequently observed. These alterations are reversible when the underlying metabolic disturbance is effectively addressed. We suggest the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2* weighted imaging. Our cases substantiate the significance of subcortical T2/FLAIR hypointensity as a fundamental feature of this condition. In the appropriate clinical context, the recognition of these MRI abnormalities can help prevent misdiagnosis and facilitate timely treatment.
非酮症高血糖症（NKH）是一种代谢紊乱疾病，通常在糖尿病（DM）管理不善或未被诊断的个体中观察到。癫痫发作是NKH的常见临床表现，与抗惊厥治疗相比，它们对血糖纠正的反应往往更好。MRI扫描可能显示皮质下T2/液体衰减反转恢复（FLAIR）成像低信号以及皮质改变，包括皮质灰质T2/FLAIR成像高信号和皮质或软脑膜强化，尽管皮质异常较少见。当潜在的代谢紊乱得到有效解决时，这些改变是可逆的。我们使用T2*加权成像提示铁蓄积作为皮质下T2低信号的一种机制。我们的病例证实了皮质下T2/FLAIR低信号作为这种疾病基本特征的重要性。在适当的临床背景下，认识到这些MRI异常有助于防止误诊并促进及时治疗。
