Central pontine myelinolysis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Brain and spinal cord MRIs may be helpful in the diagnosis of Central pontine myelinolysis. Findings on MRI diagnostic of Central pontine myelinolysis include: Symmetric signal intensity abnormality in the central pons at T2-weighted and FLAIR imaging which may progress to classic hyperintense “trident-shaped” central pontine abnormality, with sparing of the ventrolateral pons and corticospinal tracts, decreased T1 signal intensity, fluid attenuated inversion recovery (FLAIR) hyperintense lesion in the pons and intramedullary central T2 hyperintensity at axial T2W of spinal cord and sagittal T2W of thoracic spinal cord.

MRI

Brain and spinal cord MRIs may be helpful in the diagnosis of Central pontine myelinolysis. Findings on MRI diagnostic of Central pontine myelinolysis include:[1][2]

  • Symmetric signal intensity abnormality in the central pons at T2-weighted and FLAIR imaging
    • This may progress to classic hyperintense “trident-shaped” central pontine abnormality, with sparing of the ventrolateral pons and corticospinal tracts
  • Decreased T1 signal intensity
  • Fluid attenuated inversion recovery (FLAIR) hyperintense lesion in the pons
  • Intramedullary central T2 hyperintensity at axial T2W of spinal cord and sagittal T2W of thoracic spinal cord

References

  1. Ruzek KA, Campeau NG, Miller GM (2004). "Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging". AJNR Am J Neuroradiol. 25 (2): 210–3. PMID 14970019.
  2. Jacob S, Gupta H, Nikolic D, Gundogdu B, Ong S (2014). "Central pontine and extrapontine myelinolysis: the great masquerader-an autopsy case report". Case Rep Neurol Med. 2014: 745347. doi:10.1155/2014/745347. PMC 3970353. PMID 24716023.

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