XIE Pinnan1, CHEN Qi2, XU Jingxuan2, WANG Yingying2, TAO Yuanping2, XIE Yibing1, WU Aiqin2, XU Chongyong2
1.Department of Radiology, Yongjia People’s Hospital, Wenzhou, 325100; 2.Department of Radiology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027
Abstract： Objective: To study the dynamic MRI characteristics of benzene toxic encephalopathy. Methods: Complete imaging and clinical data of 35 cases with benzene toxic encephalopathy were collected from 4 hospitals of Wenzhou between March 2009 and November 2016. The imaging characteristics of benzene toxic encephalopathy were retrospectively analyzed. Results: All patients had a definite history of benzene exposure, acute or chronic onset. The clinical manifestations included the damage of central nerve system, the decline of routine blood leucocytes, the abnormality of EEG and the rise of cerebrospinal fluid pressure in lumbar puncture, et al. The arc zone of subcortical white matter fiber was invaded in 35 cases of benzene toxic encephalopathy on MRI scan, demonstrating a sign of “kwai petals” or “flame” shape. “Butterfly” change on both dentate nuclei of cerebellum was seen in 33 cases. The number of external capsule and lentiform nucleus was involved in 28 cases and 16 cases. All lesions demonstrated low signal on T1WI, high signal on T2WI, FLAIR and DWI. High or iso-signal on ADC images appeared in 26 cases and low signal in 9 cases. In 3 cases of MRS examination, the peak of Cho and Cr slightly elevated in 1 case, and no abnormality in 2 cases. No obvious changes appeared on MRI contrast enhancement, SWI and MRA. Conclusion: MRI manifestations of benzene toxic encephalopathy have some characteristics. Combined with the history, MRI can reduce the misdiagnosis of the disease and provide reference for clinical diagnosis and treatment.
