PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(01): 36-42
DOI: 10.4103/0971-3026.202961
Neuroimaging and Head & Neck

Evaluation of MR perfusion abnormalities in organophosphorus poisoning and its correlation with SPECT

K Uday Bhanu
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Niranjan Khandelwal
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Sameer Vyas
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Paramjeet Singh
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Anuj Prabhakar
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
B R Mittal
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ashish Bhalla
Department of Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Institutsangaben Financial support and sponsorship Nil.
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

Abstract

Aim: Acute organophosphate (OP) pesticide poisoning causes substantial morbidity and mortality worldwide. Many imaging modalities, such as computerized tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT) of the brain, have been used for quantitative assessment of the acute brain insult caused by acute OP poisoning. Perfusion defects on SPECT in acutely poisoned patients with OPs have been described, however, MR perfusion abnormalities have not been described in the literature. MR perfusion Imaging has the advantage of having higher spatial resolution, no radiation, and better availability. Materials and Methods:In this prospective study, 20 patients who ingested OP compounds were included. All the patients underwent brain SPECT on a dual head SPECT gamma camera and MRI brain on a 1.5T MR system. Neurocognitive tests were performed for all patients.Results: SPECT showed perfusion defects in 7 patients and total number of perfusion defects were 29. On MR perfusion, based on the cut-off values of normalized cerebral blood volume (nCBV) ratios and normalized cerebral blood flow (nCBF) ratios, the total number of patients showing perfusion defects were 6 and 8; and the total number of perfusion defects were 29 and 45, respectively. There was significant difference of the nCBV ratios and nCBF ratios between the control group (n = 20) and positive patients group (n = 6 and n = 8, respectively) (P > 0.05). All the defects seen on SPECT were well appreciated on nCBF maps (MRI perfusion) suggestive of 100% correlation. Conclusion: MR perfusion imaging can be used as an effective modality for evaluation in acute OP poisoning.

Keywords

Magnetic resonance imaging - organophosphorus poisoning - single photon emission computed tomography


Publikationsverlauf

Artikel online veröffentlicht:
27. Juli 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Karalliedde L, Senanayake N. Organophosphorus Insecticide Poisoning. Br J Anaesth 1989;63:736-50.
  • 2 Joseph A, Abraham S, Muliyil JP, George K, Prasad J, Minz S, et al. Evaluation of suicide rates in rural India using verbal autopsies, 1994-9. BMJ 2003;326:1121-2.
  • 3 Phillips MR, Li X, Zhang Y. Suicide rates in China, 1995–99. Lancet 2002;359:835-40.
  • 4 Murali R, Bhalla A, Singh D, Singh S. Acute pesticide poisoning: 15 years experience of a large North-West Indian hospital. Clin Toxicol 2009;47:35-8.
  • 5 Peter JV, Cherian AM. Organic insecticides. Anaesth Intensive Care 2000;28:11-21.
  • 6 Peter JV, Sudarsan TI, Moran JL. Clinical features of organophosphate poisoning: A review of different classification systems and approaches. Indian J Crit Care Med 2014;18:735-45.
  • 7 Kim YB, Hur GH, Shin S, Sok DE, Kang JK, Lee YS. Organophosphate-induced brain injuries: Delayed apoptosis mediated by nitric oxide. Environ Toxicol Pharmacol 1999;7:147-52.
  • 8 Leibson T, Lifshitz M. Organophosphate and carbamate poisoning: Review of the current literature and summary of clinical and laboratory experience in southern Israel. Isr Med Assoc J 2008;10:767-70.
  • 9 King AM, Aaron CK. Organophosphate and Carbamate Poisoning. Emerg Med Clin North Am 2015;33:133-51.
  • 10 Banks CN, Lein PJ. A Review of Experimental Evidence Linking Neurotoxic Organophosphorus Compounds and Inflammation. Neurotoxicology 2012;33:575-84.
  • 11 Singh S, Sharma N. Neurological syndromes following organophosphate poisoning. Neurol India 2000;48:308-13.
  • 12 Wang J, Shao Y, Shi K, Yang H, Li M. Restricted diffusion in the splenium of the corpus callosum in organophosphate induced delayed neuropathy: Case report and review of literatures. Int J Clin Exp Med 2015;8:14246-50.
  • 13 Panda AK, Bala K, Bhirud L. Extrapyramidal syndrome. BMJ Case Rep 2014;2014.
  • 14 Teke E, Sungurtekin H, Sahiner T, Atalay H, Gur S. Organophosphate poisoning case with atypical clinical survey and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry 2004;75:936-7.
  • 15 Testylier G, Lahrech H, Montigon O, Foquin A, Delacour C, Bernabé D, et al. Cerebral edema induced in mice by a convulsive dose of soman. Evaluation through diffusion-weighted magnetic resonance imaging and histology. Toxicol Appl Pharmacol 2007;220:125-37.
  • 16 Sette G, Baron JC, Mazoyer B, Levasseur M, Pappata S, Crouzel C. Local Brain Haemodynamics and Oxygen Metabolism in Cerebrovascular Disease. Brain 1989;112:931-51.
  • 17 Mittal T, Gupta N, Kohli A, Bhalla A, Singh B, Singh S. Correlation of defects in regional cerebral blood flow determined by 99mTc SPECT with residual neurocognitive testing abnormalities during and 3 months post exposure in acutely poisoned patients with organophosphates. Clin Toxicol 2011;49:464-70.
  • 18 Günes I, Yilmazlar A, Sarikaya I, Ozyurt G. Acute organophosphate poisoning - Tc-99m HMPAO SPECT imaging of the brain. A report of two cases. Clin Nucl Med 1994;19:330-2.
  • 19 Yilmazlar A, Ozyurt G. Brain involvement in organophosphate poisoning. Environ Res 1997;74:104-9.
  • 20 Rosenstock L, Keifer M, Daniell WE, McConnell R, Claypoole K. Chronic central nervous system effects of acute organophosphate pesticide intoxication. The Pesticide Health Effects Study Group. Lancet 1991;338:223-7.
  • 21 Steenland K, Jenkins B, Ames RG, O'Malley M, Chrislip D, Russo J. Chronic neurological sequelae to organophosphate pesticide poisoning. Am J Public Health 1994;84:731-6.
  • 22 Ozyurt G, Kaya FN, Kahveci F, Alper E. Comparison of SPECT findings and neuropsychological sequelae in carbon monoxide and organophosphate poisoning. Clin Toxicol Phila Pa 2008;46:218-21.