Hantson P, Duprez T, Mahieu P
Department of Intensive Care, Cliniques Universitaires St-Luc, Brussels, Belgium.
J Toxicol Clin Toxicol. 1997;35(2):151-61. doi: 10.3109/15563659709001186.
To define specific brain magnetic resonance features in methanol intoxicated patients and to evaluate the clinical relevance of monitoring these features.
During the past decade magnetic resonance imaging has proven to be an exquisitely sensitive modality in depicting subtle water changes in diseased areas of the brain, allowing the definition of high-risk structures in numerous pathological conditions.
Four patients admitted to our institution for acute methanol intoxication were repeatedly evaluated by brain magnetic resonance imaging or a combination of computed tomography and magnetic resonance imaging. Common features of initial brain status were shown in all four cases and compared to those of patients presenting with other intoxications or critical deprivation states.
Preferential localization of methanol-induced lesions within the putamina was observed in all four cases. This finding is specific compared to intoxication by other substances like carbon monoxide, or in the critical phase of metabolic disorders. The striking regression of the putaminal lesions on follow-up magnetic resonance examinations correlated with complete neurological recovery and the absence of extrapyramidal disturbance. Two patients exhibited discrete symmetric additional lesions in the medial areas of the parieto-occipital lobes. In a third one, the occipital lesions were severe. All three suffered from permanent visual impairment. The fourth patient, in whom magnetic resonance examinations failed to reveal any occipital lesion, never complained of visual disturbance though signs of optic neuropathy were detected in the visual evoked potentials.
Magnetic resonance imaging appeared as a well suited neuroimaging modality in methanol intoxicated patients both in revealing a specific pattern of brain lesions and in demonstrating valuable correlation between evolution of brain changes on magnetic resonance images and clinical outcome.
确定甲醇中毒患者特定的脑磁共振特征，并评估监测这些特征的临床相关性。
在过去十年中，磁共振成像已被证明是一种极其敏感的方式，可描绘脑部病变区域细微的水分变化，从而在众多病理状况下确定高风险结构。
对我院收治的4例急性甲醇中毒患者，反复进行脑磁共振成像检查，或采用计算机断层扫描与磁共振成像相结合的检查方法。展示了所有4例患者初始脑状态的共同特征，并与其他中毒或严重营养缺乏状态患者的特征进行比较。
所有4例患者均观察到甲醇诱导的病变在壳核内有优先定位。与一氧化碳等其他物质中毒或代谢紊乱的关键阶段相比，这一发现具有特异性。随访磁共振检查显示壳核病变显著消退，这与神经功能完全恢复及锥体外系障碍的缺失相关。2例患者在顶枕叶内侧区域出现离散对称的额外病变。第3例患者枕叶病变严重。这3例患者均患有永久性视力损害。第4例患者磁共振检查未发现任何枕叶病变，尽管视觉诱发电位检测到视神经病变迹象，但该患者从未诉说过视觉障碍。
磁共振成像似乎是甲醇中毒患者一种非常合适的神经影像学检查方式，既能揭示特定的脑病变模式，又能显示磁共振图像上脑变化的演变与临床结局之间的有价值关联。
