MR imaging of the central nervous system in diving-related decompression illness.
OBJECTIVE
This investigation was conducted to determine whether MR imaging showed cerebral or spinal damage in acute diving-related decompression illness, a term that includes decompression sickness (DCS) and arterial gas embolism (AGE).


METHODS
A total of 16 divers with dysbaric injuries were examined after the initiation of therapeutic recompression. Their injuries comprised: neurological DCS II n = 8; AGE n = 7; combined cerebral-AGE/spinal-DCS n = 1. T1- and T2-weighted images of the brain were obtained in 2 planes. In addition, the spinal cord was imaged in 7 subjects. The imaging findings were correlated with the neurological symptoms.


RESULTS
MR images of the head showed ischemic cerebrovascular lesions in 6/8 patients with AGE but showed focal hyperintensities in only 2/8 divers with DCS. Spinal cord involvement was detected in 1/7 examinations, which was the combined cerebral-AGE/spinal-DCS case. There was agreement between the locations of the documented lesions and the clinical manifestations.


CONCLUSIONS
MR readily detects cerebral damage in AGE but yields low sensitivity in DCS. A negative MR investigation cannot rule out AGE or DCS. However, MR is useful in the examination of patients with decompression illness.
Reuter
M
M
Department of Diagnostic Radiology, Christian Albrechts University, Kiel, Germany.
Tetzlaff
K
K
Hutzelmann
A
A
Fritsch
G
G
Steffens
J C
JC
Bettinghausen
E
E
Heller
M
M
D000328:Adult; D001469:Barotrauma / Q000175:diagnosis; D001927:Brain Diseases / Q000175:diagnosis*; D001929:Brain Edema / Q000175:diagnosis; D002545:Brain Ischemia / Q000175:diagnosis; D002526:Cerebellar Diseases / Q000175:diagnosis; D002540:Cerebral Cortex / Q000473:pathology; D003665:Decompression Sickness / Q000175:diagnosis*; D004242:Diving / Q000293:injuries*; D004618:Embolism, Air / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000473:pathology; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis*