MRI findings in osmotic myelinolysis.
OBJECTIVE
Osmotic myelinolysis is a distinctive clinical syndrome with characteristic CT and MR features. This study was undertaken to determine the MR appearance of these lesions on T1 and T2-weighted, and diffusion-weighted imaging (DWI) sequences with apparent diffusion coefficient (ADC) mapping.


METHODS
We describe six patients who presented with deranged serum sodium levels and subsequently developed osmotic myelinolysis. CT and MRI scans were retrospectively reviewed, including the advanced functional MR sequence of DWI with ADC mapping.


RESULTS
Both cerebral white matter and pontine lesions were typically hypo and hyper-intense on T1 and T2W sequences respectively. Lesions were mildly hyperintense on isotropic DWI images with elevation of the ADC.


CONCLUSIONS
MRI is superior to CT in depicting lesions in osmotic myelinolysis. DWI with ADC mapping suggests that osmotic myelinolysis is not simply a demyelinating disorder but has similarities to multiple sclerosis.
Chua
G C
GC
Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Republic of Singapore. cgc99@hotmail.com
Sitoh
Y Y
YY
Lim
C C
CC
Chua
H C
HC
Ng
P Y
PY
D000328:Adult; D004058:Diffusion; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed