, Volume 61, Issue 1, pp 13–15 | Cite as

“Pseudo” T1-weighted appearance of the brain on FLAIR: unmasking the extent of gray matter involvement on susceptibility-weighted imaging in chronic toluene abuse

  • Charlie Chia-Tsong HsuEmail author
  • E. Mark Haacke
  • Chinthaka Heyn
  • Kosuke Kato
  • Trevor William Watkins
  • Timo Krings
Letter to the Editor

Dear Editor-in-Chief,

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...


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Rosenberg NL, Kleinschmidt-DeMasters BK, Davis KA, Dreisbach JN, Hormes JT, Filley CM (1988) Toluene abuse causes diffuse central nervous system white matter changes. Ann Neurol 23:611–614CrossRefGoogle Scholar
  2. 2.
    Filley CM, Halliday W, Kleinschmidt-DeMasters BK (2004) The effects of toluene on the central nervous system. J Neuropathol Exp Neurol 63:1–12CrossRefGoogle Scholar
  3. 3.
    Caldemeyer KS, Armstrong SW, George KK, Moran CC, Pascuzzi RM (1996) The spectrum of neuroimaging abnormalities in solvent abuse and their clinical correlation. J Neuroimaging 6:167–173CrossRefGoogle Scholar
  4. 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
  5. 5.
    Ohnuma A, Kimura I, Saso S (1995) MRI in chronic paint-thinner intoxication. Neuroradiology 37:445–446CrossRefGoogle Scholar
  6. 6.
    Kamran S, Bakshi R (1998) MRI in chronic toluene abuse: low signal in the cerebral cortex on T2-weighted images. Neuroradiology 40:519–521CrossRefGoogle Scholar
  7. 7.
    Aydin K, Kircan S, Sarwar S, Okur O, Balaban E (2009) Smaller gray matter volumes in frontal and parietal cortices of solvent abusers correlate with cognitive deficits. AJNR Am J Neuroradiol 30:1922–1928CrossRefGoogle Scholar
  8. 8.
    Aydin K, Sencer S, Ogel K, Genchellac H, Demir T, Minareci O (2003) Single-voxel proton MR spectroscopy in toluene abuse. Magn Reson Imaging 21:777–785CrossRefGoogle Scholar
  9. 9.
    Thomas M, Jankovic J (2004) Neurodegenerative disease and iron storage in the brain. Curr Opin Neurol 17:437–442CrossRefGoogle Scholar
  10. 10.
    Mills E, Dong X, Wang F, Xu H (2010) Mechanisms of brain iron transport: insight into neurodegeneration and CNS disorders. Future Med Chem 2:51–64CrossRefGoogle Scholar
  11. 11.
    Escobar A, Aruffo C (1980) Chronic thinner intoxication: clinico-pathologic report of a human case. J Neurol Neurosurg Psychiatry 43:986–994CrossRefGoogle Scholar
  12. 12.
    Ghassaban K, Liu S, Jiang C, Haacke EM (2018) Quantifying iron content in magnetic resonance imaging. NeuroImage.

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medical ImagingGold Coast University HospitalSouthportAustralia
  2. 2.Departments of Radiology and Biomedical EngineeringWayne State UniversityDetroitUSA
  3. 3.Department of Medical ImagingSunnybrook Health Sciences Centre and University of TorontoTorontoCanada
  4. 4.Physical SciencesSunnybrook Research InstituteTorontoCanada
  5. 5.Department of Medical ImagingPrincess Alexandra HospitalBrisbaneAustralia
  6. 6.Joint Department of Medical ImagingToronto Western Hospital and University Health NetworkTorontoCanada

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