Kosin Med J.  2021 Jun;36(1):51-55. 10.7180/kmj.2021.36.1.51.

Unusual Magnetic Resonance Imaging Findings Contrast-induced Encephalopathy following Cerebral Angiography

• Cho WH
• Lee JH
• Lee TH
• Choi CH
• Ko JK

• KMID: 2517226
• DOI: http://doi.org/10.7180/kmj.2021.36.1.51

Abstract

Contrast-induced encephalopathy (CIE) following cerebral angiography has similar clinical presentations to ischemic complications of cerebral angiography. Neurologic deficits in CIE are mostly transient, but those caused by acute cerebral infarction (ACI) as ischemic complications of cerebral angiography may be permanent. Therefore, distinguishing CIE from ACI is important. Diffusion restriction on magnetic resonance imaging (MRI) implies ACI, while hyperintensity on diffusion weighted imaging (DWI) without correlation on the apparent diffusion coefficient (ADC) map implies CIE. We reported a rare case of CIE with diffusion restriction on MRI following cerebral angiography that mimicked MRI findings of ACI. The mechanism of this phenomenon remains unknown and requires further investigation.

Keyword

Contrast media; Extravasation; Magnetic resonance imaging; Neurotoxicity

Figure

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  Fig. 1 Brain computed tomography following cerebral angiography shows marked enhancement throughout the right cerebral cortex with concordant diffuse swelling, indicating of contrast-induced encephalopathy.

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  Fig. 2 Magnetic resonance imaging following cerebral angiography shows extensive cortical and striatal hyperintensity within the right hemisphere on diffusion weighted image (left) and corresponding hypointense signal alterations on the apparent diffusion coefficient map (right) nearly matching with the findings of computed tomography.

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  Fig. 3 Follow-up magnetic resonance imaging performed 1 week after cerebral angiography reveals complete reversal of the previously areas on diffusion weighted image (left) and the apparent diffusion coefficient map (right).

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