Abstract | BACKGROUND AND PURPOSE: The dynamics of brain-water content associated with hemodialysis in patients with severe azotemia remains obscure. To investigate whether either interstitial or cytotoxic edema is responsible for dialysis disequilibrium syndrome (DDS), we used diffusion-weighted MR imaging (DWI) to measure the apparent diffusion coefficient (ADC), which is sensitive for detecting tissue water dynamics. METHODS: Eight consecutive patients with end stage renal disease ( ESRD) and blood urea nitrogen level of more than 100 mg/dL (160.9 +/- 53.1 mg/dL) were recruited. Conventional MR images, DWI, and clinical manifestations were obtained before and after the 1st hemodialysis. The ADC values were determined for regions of normal-appearing gray and white matter and for regions of hyperintensity of white matter on T2-weighted MR imaging. RESULTS: Foci of bright areas of white matter were found in all patients on T2-weighted images. The ADC values of the patients with ESRD, in white matter and gray matter before and after hemodialysis, were greater than those of the healthy controls (P < .005). Regarding the impact of hemodialysis, the ADC of frontal lobe white matter increased significantly after hemodialysis (1.09 +/- 0.11 versus 1.03 +/- 0.11, P = .036). We did not find the specific area of brain edema reported in posterior leukoencephalopathy and the osmotic demyelination syndrome. CONCLUSIONS:
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Authors | C L Chen, P H Lai, K J Chou, P T Lee, H M Chung, H C Fang |
Journal | AJNR. American journal of neuroradiology
(AJNR Am J Neuroradiol)
Vol. 28
Issue 1
Pg. 68-71
(Jan 2007)
ISSN: 0195-6108 [Print] United States |
PMID | 17213426
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Aged
- Azotemia
(diagnosis, therapy)
- Brain
(pathology)
- Brain Edema
(diagnosis)
- Diagnosis, Differential
- Diffusion Magnetic Resonance Imaging
- Female
- Glomerulonephritis
(complications, diagnosis, therapy)
- Humans
- Male
- Middle Aged
- Nephritis, Interstitial
(complications, diagnosis, therapy)
- Reference Values
- Renal Dialysis
- Sensitivity and Specificity
- Uremia
(diagnosis, therapy)
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