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An MRI-Based Quantification for Correlation of Imaging Biomarker and Clinical Performance in Chronic Phase of Carbon Monoxide Poisoning

  • Lee, Aleum (Department of Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Hwang, Ji-sun (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Bae, Won-kyung (Department of Radiology, Soonchunhyang University Cheonan Hospital) ;
  • Park, Jai-soung (Department of Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Goo, Dong Erk (Department of Radiology, Soonchunhyang University Seoul Hospital) ;
  • Park, Sung-Tae (Department of Radiology, Soonchunhyang University Seoul Hospital)
  • Received : 2019.04.22
  • Accepted : 2019.05.22
  • Published : 2019.09.30

Abstract

Purpose: The purpose of this study was to determine the relation between quantitative magnetic resonance imaging biomarkers, and clinical performances in chronic phase of carbon monoxide intoxication. Materials and Methods: Eighteen magnetic resonance scans and cognitive evaluations were performed, on patients with carbon monoxide intoxication in chronic phase. Apparent diffusion coefficient (ADC) ratios of affected versus unaffected centrum semiovale, and corpus callosum were obtained. Signal intensity (SI) ratios between affected centrum semiovale, and normal pons in T2-FLAIR (fluid-attenuated inversion recovery) images were obtained. The Mini-Mental State Exam, and clinical outcome scores were assessed. Correlation coefficients were calculated, between MRI and clinical markers. Patients were further classified into poor-outcome and good-outcome groups based on clinical performance, and imaging parameters were compared. T2-SI ratio of centrum semiovale was compared, with that of 18 sex-matched and age-matched controls. Results: T2-SI ratio of centrum semiovale was significantly higher in the poor-outcome group, than that in the good-outcome group and was strongly inversely correlated, with results from the Mini-Mental State Exam. ADC ratios of centrum semiovale were significantly lower in the poor outcome group than in the good outcome group, and were moderately correlated with the Mini-Mental State Exam score. Conclusion: A higher T2-SI and a lower ratio of ADC values in the centrum semiovale, may indicate presence of more severe white matter injury and clinical impairment. T2-SI ratio and ADC values in the centrum semiovale, are useful quantitative imaging biomarkers for correlation with clinical performance in individuals with carbon monoxide intoxication.

Keywords

References

  1. Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med 2007;34:163-168
  2. Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med 2009;360:1217-1225 https://doi.org/10.1056/NEJMcp0808891
  3. Ernst A, Zibrak JD. Carbon monoxide poisoning. N Engl J Med 1998;339:1603-1608 https://doi.org/10.1056/NEJM199811263392206
  4. Beppu T. The role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature. AJNR Am J Neuroradiol 2014;35:625-631 https://doi.org/10.3174/ajnr.A3489
  5. Kim JH, Chang KH, Song IC, et al. Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol 2003;24:1592-1597
  6. Kinoshita T, Sugihara S, Matsusue E, Fujii S, Ametani M, Ogawa T. Pallidoreticular damage in acute carbon monoxide poisoning: diffusion-weighted MR imaging findings. AJNR Am J Neuroradiol 2005;26:1845-1848
  7. Ginsberg MD. Carbon monoxide intoxication: clinical features, neuropathology and mechanisms of injury. J Toxicol Clin Toxicol 1985;23:281-288 https://doi.org/10.3109/15563658508990635
  8. Lapresle J, Fardeau M. The central nervous system and carbon monoxide poisoning. II. Anatomical study of brain lesions following intoxication with carbon monixide (22 cases). Prog Brain Res 1967;24:31-74 https://doi.org/10.1016/S0079-6123(08)60181-8
  9. Chen NC, Huang CW, Lui CC, et al. Diffusion-weighted imaging improves prediction in cognitive outcome and clinical phases in patients with carbon monoxide intoxication. Neuroradiology 2013;55:107-115 https://doi.org/10.1007/s00234-012-1102-0
  10. Chang CC, Lee YC, Chang WN, et al. Damage of white matter tract correlated with neuropsychological deficits in carbon monoxide intoxication after hyperbaric oxygen therapy. J Neurotrauma 2009;26:1263-1270 https://doi.org/10.1089/neu.2008.0619
  11. McKinney AM, Kieffer SA, Paylor RT, SantaCruz KS, Kendi A, Lucato L. Acute toxic leukoencephalopathy: potential for reversibility clinically and on MRI with diffusion-weighted and FLAIR imaging. AJR Am J Roentgenol 2009;193:192-206 https://doi.org/10.2214/AJR.08.1176
  12. Gale SD, Hopkins RO, Weaver LK, Bigler ED, Booth EJ, Blatter DD. MRI, quantitative MRI, SPECT, and neuropsychological findings following carbon monoxide poisoning. Brain Inj 1999;13:229-243 https://doi.org/10.1080/026990599121601
  13. Parkinson RB, Hopkins RO, Cleavinger HB, et al. White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology 2002;58:1525-1532 https://doi.org/10.1212/WNL.58.10.1525
  14. Takaoka M, Tabuse H, Kumura E, et al. Semiquantitative analysis of corpus callosum injury using magnetic resonance imaging indicates clinical severity in patients with diffuse axonal injury. J Neurol Neurosurg Psychiatry 2002;73:289-293 https://doi.org/10.1136/jnnp.73.3.289
  15. Varella PP, Santiago JF, Carrete H Jr, et al. Relationship between fluid-attenuated inversion-recovery (FLAIR) signal intensity and inflammatory mediator's levels in the hippocampus of patients with temporal lobe epilepsy and mesial temporal sclerosis. Arq Neuropsiquiatr 2011;69:91-99 https://doi.org/10.1590/S0004-282X2011000100018
  16. Kang Y, Xu X, Cheng L, et al. Two-dimensional speckle tracking echocardiography combined with high-sensitive cardiac troponin T in early detection and prediction of cardiotoxicity during epirubicine-based chemotherapy. Eur J Heart Fail 2014;16:300-308 https://doi.org/10.1002/ejhf.8
  17. Jain KK. Carbon monoxide and other tissue poisons. In Jain KK, ed. Textbook of hyperbaric medicine. 5th ed. Cambridge, MA: Hogrefe Publishing, 2009:111-133
  18. Porter SS, Hopkins RO, Weaver LK, Bigler ED, Blatter DD. Corpus callosum atrophy and neuropsychological outcome following carbon monoxide poisoning. Arch Clin Neuropsychol 2002;17:195-204 https://doi.org/10.1093/arclin/17.2.195
  19. Lo CP, Chen SY, Lee KW, et al. Brain injury after acute carbon monoxide poisoning: early and late complications. AJR Am J Roentgenol 2007;189:W205-211 https://doi.org/10.2214/AJR.07.2425
  20. Vieregge P, Klostermann W, Blumm RG, Borgis KJ. Carbon monoxide poisoning: clinical, neurophysiological, and brain imaging observations in acute disease and follow-up. J Neurol 1989;236:478-481 https://doi.org/10.1007/BF00328511
  21. Pracyk JB, Stolp BW, Fife CE, Gray L, Piantadosi CA. Brain computerized tomography after hyperbaric oxygen therapy for carbon monoxide poisoning. Undersea Hyperb Med 1995;22:1-7
  22. Sener RN. Acute carbon monoxide poisoning: diffusion MR imaging findings. AJNR Am J Neuroradiol 2003;24:1475-1477
  23. Murata T, Kimura H, Kado H, et al. Neuronal damage in the interval form of CO poisoning determined by serial diffusion weighted magnetic resonance imaging plus 1H-magnetic resonance spectroscopy. J Neurol Neurosurg Psychiatry 2001;71:250-253 https://doi.org/10.1136/jnnp.71.2.250
  24. Pierpaoli C, Righini A, Linfante I, Tao-Cheng JH, Alger JR, Di Chiro G. Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study. Radiology 1993;189:439-448 https://doi.org/10.1148/radiology.189.2.8210373
  25. Beppu T, Fujiwara S, Nishimoto H, et al. Fractional anisotropy in the centrum semiovale as a quantitative indicator of cerebral white matter damage in the subacute phase in patients with carbon monoxide poisoning: correlation with the concentration of myelin basic protein in cerebrospinal fluid. J Neurol 2012;259:1698-1705 https://doi.org/10.1007/s00415-011-6402-5
  26. Fujiwara S, Beppu T, Nishimoto H, et al. Detecting damaged regions of cerebral white matter in the subacute phase after carbon monoxide poisoning using voxel-based analysis with diffusion tensor imaging. Neuroradiology 2012;54:681-689 https://doi.org/10.1007/s00234-011-0958-8
  27. Pandya DN, Karol EA, Heilbronn D. The topographical distribution of interhemispheric projections in the corpus callosum of the rhesus monkey. Brain Res 1971;32:31-43 https://doi.org/10.1016/0006-8993(71)90153-3