Korean J Radiol.  2012 Dec;13(6):808-811. 10.3348/kjr.2012.13.6.808.

Uremic Encephalopathy with Atypical Magnetic Resonance Features on Diffusion-Weighted Images

• Kang E
• Jeon SJ
• Choi SS

• KMID: 1397513
• DOI: http://doi.org/10.3348/kjr.2012.13.6.808

Abstract

Uremic encephalopathy is a well-known disease with typical MR findings including bilateral vasogenic or cytotoxic edema at the cerebral cortex or basal ganglia. Involvement of the basal ganglia has been very rarely reported, typically occurring in uremic-diabetic patients. We recently treated a patient who had non-diabetic uremic encephalopathy with an atypical lesion distribution involving the supratentorial white matter, without cortical or basal ganglia involvement. To the best of our knowledge, this is only the second reported case of non-diabetic uremic encephalopathy with atypical MR findings.

Keyword

Uremic encephalopathy; Magnetic resonance imaging; Diffusion-weighted imaging

MeSH Terms

Adult
Brain Diseases, Metabolic/*diagnosis
*Diffusion Magnetic Resonance Imaging
Humans
Male
Uremia/*complications

Figure

• 

  Fig. 1 Brain MRI in 36-year-old man with right facial palsy and motor weakness. Brain MRI performed upon admission. Initial FLAIR reveals confluent high signal intensities of cerebral white mater, sparing cortex and basal ganglia (A). These lesions show high signal intensities on DWI and decreased ADC values (B-E). FLAIR = fluid-attenuated inversion recovery, DWI = diffusion-weighted imaging, ADC = apparent diffusion coefficient. Follow-up magnetic resonance (MR) scan obtained after 7 days, when symptoms had improved. MR images show that lesions, which showed abnormal signal intensities, are completely resolved (F-I).

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