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Diffusion-weighted imaging improves prediction in cognitive outcome and clinical phases in patients with carbon monoxide intoxication

  • Functional Neuroradiology
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Abstract

Introduction

Changes in apparent diffusion coefficient (ADC) values often reflect tissue injury. Use of ADC as a surrogate marker to assess clinical phases has not been systemically applied in patients with carbon monoxide (CO) intoxication.

Methods

Fifty-nine magnetic resonance imaging scans and cognitive evaluations were performed in 47 patients with CO intoxication and compared with 22 sex- and age-matched controls. The patients were further classified into three groups based on the clinical phases, namely, acute (within 2 weeks), delayed neuropsychiatric (2 weeks to 6 months), and chronic (>1 year) groups. The ADC values were measured in 16 regions of interests (ROIs) and correlated with cognitive test scores.

Results

Among the 59 evaluations, 15 were in the acute, 26 in the delayed neuropsychiatric, and 18 in the chronic groups. Among the ROIs, significant elevations of ADC values were found in the corpus callosum and globus pallidus in all three CO phases compared with the controls, and the ADC values were highest in the chronic phases. In contrast, the ADC values in peripheral gray matter and white matter were highest in the delayed neuropsychiatric group. Both globus pallidus and corpus callosum ADC values correlated with multiple cognitive test scores.

Conclusion

Using ADC as a surrogate marker, the globus pallidus and corpus callosum can be considered to be two vulnerable structures in the gray and white matter. Significant differences between ADC values correlated well with clinical phase and cognitive performance.

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Acknowledgments

The authors thank Drs. T.L. Huang, P.Y. Lin, Y. Lee, and C.H. Lin from the Department of Psychiatry at the Kaohsiung Chang Gung Memorial Hospital and Dr. C.W. Chiang from the Department of Neurology at the Kaohsiung Naval General Hospital for referring the patients with carbon monoxide intoxication. This work was supported in part by grants CMRPG890871 and CMRPG8A0511 from the Chang Gung Memorial Hospital.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, #123, Ta-Pei Road, Niaosung, Kaohsiung County, 833, Taiwan

    Nai-Ching Chen, Chi-Wei Huang, Wen-Neng Chang & Chiung-Chih Chang

  2. Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Chun-Chung Lui & Chen-Chang Lee

  3. Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Shu-Hua Huang

  4. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Ching Chen

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  1. Nai-Ching Chen
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Correspondence to Chiung-Chih Chang.

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Chen, NC., Huang, CW., Lui, CC. et al. Diffusion-weighted imaging improves prediction in cognitive outcome and clinical phases in patients with carbon monoxide intoxication. Neuroradiology 55, 107–115 (2013). https://doi.org/10.1007/s00234-012-1102-0

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  • DOI: https://doi.org/10.1007/s00234-012-1102-0

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