1-Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
European Congress of Radiology (ECR), 4-8 March 2015, Vienna, Austria
Published online. DOI: 10.1594/ecr2015/C-0342
- To review the main imaging patterns of central nervous system (CNS) injury occurring in the setting of acquired metabolic and hydroelectrolytic disorders. - To illustrate the imaging spectrum of these pathologies, primarily by magnetic resonance (MR) but also by computed tomography (CT).
As in diseases due to inborn errors of metabolism, CNS may be injured during acquired metabolic and ionic disturbances. Acquired metabolic disorders can occur in both adults and children, in relation nutritional deficiencies, abnormalities of glucose and electrolyte levels and impaired organ function. Specific toxins tend to affect specific regions of the CNS selectively, providing recognizable patterns radiologists should be familiar with.
Findings and procedure details:
We collected a series of cases from our Neuroradiology imaging archive, illustrated by MR and CT imaging. A small introduction to each pathology and classical clinical and imaging findings are presented. Cases displayed include: acquired hepatocerebral degeneration, disturbances of calcium/phosphorus metabolism, hypoglycemia, kernicterus, nonketotic hyperglycemia, osmotic demyelination (pontine /extrapontine), subacute combined degeneration and Wernicke encephalopathy (alcoholic/nonalcoholic).
Overall, these conditions preferentially originate lesion in the deep gray matter, with less frequent involvement of white matter and cortex; they are typically bilateral and symmetrical, with the exception of nonketotic hyperglycemia, which is usually unilateral. Although imaging patterns are not totally specific, imaging studies and mainly MRI can show suggestive lesions. Most typical location of lesions and atypical or less frequent locations should be recognized.