Shuang Xia MD, Presenter: Nothing to Disclose

Ji Qi MD, PhD, Abstract Co-Author: Nothing to Disclose

To study the imaging of central pontine myelinolysis (CPM) and extrapontine myelinolysis（EPM）after liver transplantation and value of DWI

8 patients after liver transplantation with CPM and EPM were included in our study, 4 cases of female and 4 cases of male. MR were performed on Philips 1.5T MRI system. The sequence included SE T1WI，FSE T2WI,axial SE-EPI DWI，TR/TE 6225/118.7 ms, ETL 128， FLIP 90°, thickness 5 mm， matrix 128×128，b=1000 mm2/s

4 of B type hepatitis and cirrhosis, 1 of C type hepatitis with cirrhosis from schistosome,2 of C type hepatitis and cirrhosis, 1 of cholangiogenic cirrhosis . MR demonstrated prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem sparing of the corticospinal tract and peripontine tissue.The lesion manifested high signal intensity both on DWI and ADC map indicating T2 effect and vasogenic edema. Followup MR in 2 cases 2 months later showed more prolongation of T1 and T2 than the first time and the lesion manifested isosignal on DWI and high signal intensity on ADC map suggesting increased diffusivity. Abnormal signal intensity were detected on the bilateral caudate head, globus pallidus, putamen and cerebral cortex in 3 cases

CPM should be considered when prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem, sparing of the corticospinal tract and peripontine tissue was detected for patients of posttranplantation. When combined with other area abnormality ,EPM and CPM should be considered. DWI can followup the prognosis of the lesion.

MR has been used to evaluated the patients after liver transplantation  

Xia, S, Qi, J, The Imaging of Osmotic Myelinolysis in Patients after Liver Transplantation.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6013463.html