title: Acute carbon monoxide poisoning: MR imaging findings with clinical correlation.
abstract: OBJECTIVE
  To assess the magnetic resonance imaging (MRI) findings, including diffusion-weighted imaging (DWI) in patients with acute carbon monoxide (CO) poisoning and correlate MRI findings with carboxyhemoglobin levels.
  
  
  METHODS
  The MRI examinations and medical records of seven men with a mean age of 43±16.0years (SD) (range: 25-63 years) with acute CO poisoning were reviewed. MRI examinations were analyzed with respect to lesion location, imaging presentation on T1- and T2-weighted images, and diffusion characteristics on DWI and apparent diffusion coefficient (ADC) maps. We also evaluated clinical features and laboratory findings including the presenting symptoms and signs, carboxyhemoglobin level, and treatment.
  
  
  RESULTS
  All seven patients presented with mental status change. The level of carboxyhemoglobin ranged between 8.3% and 34.8% (normal<1.5%). All seven patients (7/7, 100%) showed restricted diffusion of the lesions on ADC maps and bilateral involvement of globus pallidus. The mean ratios of ADC values was 0.63±0.15 (SD) (range: 0.46-0.92) on bilateral globi pallidi. Cerebral cortex, cerebral white matter, cerebellum, hippocampus, amygdala, splenium of corpus callosum, midbrain and insula were also involved.
  
  
  CONCLUSIONS
  Bilateral globi pallidi with restricted diffusion may be a characteristic MRI feature in patients with acute CO poisoning. However, the relationship was not certain between the carboxyhemoglobin levels and the variety or severity of MRI findings.
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, 301-721 Daejeon, South Korea.
authors.forename: D M
authors.initials: DM
authors.lastname: Kim
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, 301-721 Daejeon, South Korea. Electronic address: leeinho1974@hanmail.net.
authors.forename: I H
authors.initials: IH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, 301-721 Daejeon, South Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Radiology, Chonbuk National University Hospital, 20, Geonjiro, Deokjin-gu, Jeonju-si, 561-712 Jeollabuk-do, South Korea.
authors.forename: S-B
authors.initials: SB
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Dankook University Hospital, 16-5, San Anseo-dong, Cheonan-si, 330-715 Chungcheongnam-do, South Korea.
authors.forename: D S
authors.initials: DS
authors.lastname: Yoo
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, 301-721 Daejeon, South Korea.
authors.forename: C J
authors.initials: CJ
authors.lastname: Song
mesh_terms: D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D002249:Carbon Monoxide Poisoning / Q000000981:diagnostic imaging* / Q000628:therapy; D002263:Carboxyhemoglobin / Q000378:metabolism*; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005917:Globus Pallidus / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D013223:Statistics as Topic
chemical_list: D002263:Carboxyhemoglobin
keywords: Carbon monoxide poisoning; Diffusion-weighted imaging (DWI); Globus pallidum; Magnetic resonance imaging (MRI)