Article Figures & Data
Figures
- Fig 1.
Axial T2-weighted (2900/85/2 [TR/TE/NEX]) images in a 16-year-old patient who had inhaled toluene for 6 years.
A, High signal intensity is seen in the centrum semiovale (arrows) on both sides. The peripheral cerebral white matter and gray matter-white matter differentiation are preserved.
B, High-signal-intensity changes involve the frontal and parietal periventricular white matter (arrowheads). The pattern of white matter changes is compatible with that of the restricted type. Note that the lateral ventricles and cerebral sulci are enlarged.
- Fig 2.
MR images in a 19-year-old patient who had abused toluene for 8 years.
A, Axial T2-weighted (2620/85/2 [TR/TE/NEX]) image at the level of the brain stem shows a hyperintense lesion in the anterolateral part of pons (arrowhead). Note that gray matter-white matter differentiation is lost in the anterior part of the left temporal lobe.
B, Axial T2-weighted (2620/85/2) image at the level of lower medulla oblongata shows symmetric hyperintensity along the spinocerebellar tracts (arrowheads).
C, Sagittal T1-weighted (600/15/1) midline image shows thinning of the corpus callosum, which is more prominent in the body and genu. Note the enlarged cerebellar sulci.
D, Coronal T2-weighted image (4800/100/2) reveals a lack of signal intensity abnormality in the corpus callosum.
- Fig 3.
Axial T2-weighted MR images (3000/80/2 [TR/TE/NEX]) in a 22-year-old patient who had abused thinner for 11 years.
A, Symmetric hypointensity is present in the thalami (arrows). Symmetric hyperintensity exists in the posterior limbs of the internal capsule (arrowheads).
B, At the level of the posterior fossa, generalized increased signal intensity in the cerebellar white matter emphasizes the dentate nucleus (arrowheads).
C, At the level of midbrain, red nuclei (arrows) and substantia nigra (arrowheads) are hypointense.
D, Diffuse high-signal-intensity in the centrum semiovale causes loss of gray matter-white matter differentiation. Gray matter-white matter differentiation is preserved only in the subcortical-frontal white matter (arrow). The cerebral sulci are mildly dilated.
- Fig 4.
Axial T2-weighted (3000/80/2 [TR/TE/NEX]) images in a 16-year-old patient who had inhaled thinner for 3 years.
A and B, Bilateral, symmetric hyperintensity is present in the parietal periventricular white matter (arrowheads). Note that gray matter-white matter differentiation is preserved. The widths of the cerebral sulci are normal. A suggests that the hyperintense findings may be caused by terminal myelination, which is a normal MR imaging finding in children. However, B shows that the lesions extend to the bilateral centrum semiovale, indicating that hyperintense findings were true lesions rather than terminal myelination.
Tables
Distribution of clinical and MR imaging findings with respect to the duration of toluene abuse
Duration of Abuse (y) No. of Patients Symptoms* Neurologic Signs* Cases with Positive MR Imaging Finding (n) White Matter Changes Thalamic Hypointensity Thin Corpus Callosum Restricted Diffuse 1 8 IS (5), FG (4), ANS (5), TN (1) None 0 0 0 0 2 4 IS (4), FG (3), ANS (3), TN (1) None 0 0 0 0 3 3 IS (2), FG (3), ANS (2) ATX (2) 1 0 0 0 4 5 IS (5), FG (5), ANS (3) ATX (2), TM (2), SP (1) 3 0 0 0 5 6 IS (4), FG (5), ANS (3), TN (3) ATX (1), TM (1) 1 0 0 1 6 4 IS (3), FG (3), ANS (3), TN (3) ATX (3), TM (2) 1 2 1 1 7 3 IS (3), FG (3), ANS (3), TN (2) ATX (3), TM (3), SP (2), DA (1) 1 2 2 2 8 4 IS (4), FG (4), ANS (4), TN (2) ATX (4), TM (3), SP (3), NYS (1), DA (1) 2 2 2 2 9 3 IS (3), FG (3), ANS (3), TN (2) ATX (3), TM (3), SP (3), NYS (1), DA (1) 1 2 2 2 11 1 IS, FG, ANS, TN ATX, TM, SP, NYS, DA 0 1 1 1 * ANS indicates anosmia; ATX, ataxia; DA, dysarthria; FG, forgetfulness; IS, insomnia; NYS, nystagmus; SP, spasticity; TM, tremors; and TN, tinnitus. Numbers in parentheses the number of cases.
