“Pseudo” T1-weighted appearance of the brain on FLAIR: unmasking the extent of gray matter involvement on susceptibility-weighted imaging in chronic toluene abuse
Toluene is a readily accessible neurotoxic organic solvent present in paints, inks, glues, and thinners. Chronic toluene abuse through inhalation causes progressive debilitating neurologic complications including cognitive impairment, cerebellar, and extrapyramidal symptoms [1, 2]. White matter involvement is perhaps the most well-recognized radiologic feature of chronic toluene abuse. White matter lesions are localized to the periventricular region in early stages and become more confluent with subsequent involvement of the subcortical U-fibers [3, 4]. The extent of white matter involvement on MRI correlates with the severity of cognitive impairment [1, 2]. Less emphasized radiologic findings of toluene abuse are the involvement of cortical and central gray matter (basal ganglia and thalami) which manifests as low-signal intensity on the T2-weighted spin echo or T2*-weighted gradient echo (GRE) sequences [3, 4, 5, 6]. A causal relationship between the white and...
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No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Aydin K, Sencer S, Demir T, Ogel K, Tunaci A, Minareci O (2002) Cranial MR findings in chronic toluene abuse by inhalation. AJNR Am J Neuroradiol 23:1173–1179Google Scholar
- 12.Ghassaban K, Liu S, Jiang C, Haacke EM (2018) Quantifying iron content in magnetic resonance imaging. NeuroImage. https://doi.org/10.1016/j.neuroimage.2018.04.047