TY - JOUR
T1 - Imaging patterns of toxic and metabolic brain disorders
AU - de Oliveira, Arthur M.
AU - Paulino, Matheus V.
AU - Vieira, Ana P.F.
AU - McKinney, Alexander M.
AU - da Rocha, Antonio J.
AU - Dos Santos, Germana T.
AU - Leite, Claudia da Costa
AU - Godoy, Luis F.de Souza
AU - Lucato, Leandro T.
N1 - Publisher Copyright:
©RSNA, 2019.
PY - 2019/10
Y1 - 2019/10
N2 - Toxic and metabolic brain disorders are relatively uncommon diseases that affect the central nervous system, but they are important to recognize as they can lead to catastrophic outcomes if not rapidly and properly managed. Imaging plays a key role in determining the most probable diagnosis, pointing to the next steps of investigation, and providing prognostic information. The majority of cases demonstrate bilateral and symmetric involvement of structures at imaging, affecting the deep gray nuclei, cortical gray matter, and/or periventricular white matter, and some cases show specific imaging manifestations. When an appropriate clinical situation suggests exogenous or endogenous toxic effects, the associated imaging pattern usually indicates a restricted group of diagnostic possibilities. Nonetheless, toxic and metabolic brain disorders in the literature are usually approached in the literature by starting with common causal agents and then reaching imaging abnormalities, frequently mixing many different possible manifestations. Conversely, this article proposes a systematic approach to address this group of diseases based on the most important imaging patterns encountered in clinical practice. Each pattern is suggestive of a most likely differential diagnosis, which more closely resembles real-world scenarios faced by radiologists. Basic pathophysiologic concepts regarding cerebral edemas and their relation to imaging are introduced-an important topic for overall understanding. The most important imaging patterns are presented, and the main differential diagnosis for each pattern is discussed.
Online supplemental material is available for this article.
©RSNA, 2019.
AB - Toxic and metabolic brain disorders are relatively uncommon diseases that affect the central nervous system, but they are important to recognize as they can lead to catastrophic outcomes if not rapidly and properly managed. Imaging plays a key role in determining the most probable diagnosis, pointing to the next steps of investigation, and providing prognostic information. The majority of cases demonstrate bilateral and symmetric involvement of structures at imaging, affecting the deep gray nuclei, cortical gray matter, and/or periventricular white matter, and some cases show specific imaging manifestations. When an appropriate clinical situation suggests exogenous or endogenous toxic effects, the associated imaging pattern usually indicates a restricted group of diagnostic possibilities. Nonetheless, toxic and metabolic brain disorders in the literature are usually approached in the literature by starting with common causal agents and then reaching imaging abnormalities, frequently mixing many different possible manifestations. Conversely, this article proposes a systematic approach to address this group of diseases based on the most important imaging patterns encountered in clinical practice. Each pattern is suggestive of a most likely differential diagnosis, which more closely resembles real-world scenarios faced by radiologists. Basic pathophysiologic concepts regarding cerebral edemas and their relation to imaging are introduced-an important topic for overall understanding. The most important imaging patterns are presented, and the main differential diagnosis for each pattern is discussed.
Online supplemental material is available for this article.
©RSNA, 2019.
UR - http://www.scopus.com/inward/record.url?scp=85072968199&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072968199&partnerID=8YFLogxK
U2 - 10.1148/rg.2019190016
DO - 10.1148/rg.2019190016
M3 - Article
C2 - 31589567
AN - SCOPUS:85072968199
SN - 0271-5333
VL - 39
SP - 1672
EP - 1695
JO - Radiographics
JF - Radiographics
IS - 6
ER -