Comparison of MRI, CT, TCD and SPECT in patients with spongiform leukoencephalopathy after inhaling heroin vapor / 中华放射学杂志

ABSTRACT

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.