Study of Subclinical Cerebral Edema in Diabetic Ketoacidosis by Magnetic Resonance Imaging T2 Relaxometry and Apparent Diffusion Coefficient Maps
Cerebral edema is the most significant complication in children with diabetic ketoacidosis (DKA). Our goal was to study whether subclinical cerebral edema was preferentially vasogenic or cytotoxic. Magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and T2 relaxometry (T2R)-were obtain...
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| Veröffentlicht in: | Endocrine research 2005, Vol.31 (4), p.345-355 |
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| creator | Figueroa, Ramon E. Hoffman, William H. Momin, Zahir Pancholy, Ajay Passmore, Gregory G. Allison, Jerry |
| description | Cerebral edema is the most significant complication in children with diabetic ketoacidosis (DKA). Our goal was to study whether subclinical cerebral edema was preferentially vasogenic or cytotoxic. Magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and T2 relaxometry (T2R)-were obtained in pediatric patients presenting with severe diabetic ketoacidosis (DKA) 6-12 hours after initial DKA treatment and stabilization and 96 hours after correction of DKA. T2 relaxometry was significantly increased during treatment in both white and gray matter, in comparison to the absolute T2R values 96 hours after correction of DKA (p = .034). Classic intracellular cytotoxic edema could not be detected, based on the lack of a statistically significant decrease in ADC values. ADC values were instead elevated, implying a large component of cell membrane water diffusion, correlating with the elevated white and gray matter T2R. We discuss the findings in relation to cerebral blood volume, cerebral vasoregulatory dysfunction, and cerebral hyperemia. |
| doi_str_mv | 10.1080/07435800500451912 |
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Our goal was to study whether subclinical cerebral edema was preferentially vasogenic or cytotoxic. Magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and T2 relaxometry (T2R)-were obtained in pediatric patients presenting with severe diabetic ketoacidosis (DKA) 6-12 hours after initial DKA treatment and stabilization and 96 hours after correction of DKA. T2 relaxometry was significantly increased during treatment in both white and gray matter, in comparison to the absolute T2R values 96 hours after correction of DKA (p = .034). Classic intracellular cytotoxic edema could not be detected, based on the lack of a statistically significant decrease in ADC values. ADC values were instead elevated, implying a large component of cell membrane water diffusion, correlating with the elevated white and gray matter T2R. We discuss the findings in relation to cerebral blood volume, cerebral vasoregulatory dysfunction, and cerebral hyperemia.</description><identifier>ISSN: 0743-5800</identifier><identifier>EISSN: 1532-4206</identifier><identifier>DOI: 10.1080/07435800500451912</identifier><identifier>PMID: 16433253</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Adolescent ; Blood Chemical Analysis ; Brain Edema - blood ; Brain Edema - complications ; Brain Edema - diagnosis ; Cerebral edema ; Cerebral hyperemia ; Child ; Diabetic ketoacidosis ; Diabetic Ketoacidosis - blood ; Diabetic Ketoacidosis - complications ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods</subject><ispartof>Endocrine research, 2005, Vol.31 (4), p.345-355</ispartof><rights>2005 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-181f24baac6f4ac097c7cbae068f4ab9f72c9b3d9885b996c97b259aa1c328c73</citedby><cites>FETCH-LOGICAL-c435t-181f24baac6f4ac097c7cbae068f4ab9f72c9b3d9885b996c97b259aa1c328c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/07435800500451912$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/07435800500451912$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,777,781,4010,27904,27905,27906,59626,59732,60415,60521,61200,61235,61381,61416</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16433253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Figueroa, Ramon E.</creatorcontrib><creatorcontrib>Hoffman, William H.</creatorcontrib><creatorcontrib>Momin, Zahir</creatorcontrib><creatorcontrib>Pancholy, Ajay</creatorcontrib><creatorcontrib>Passmore, Gregory G.</creatorcontrib><creatorcontrib>Allison, Jerry</creatorcontrib><title>Study of Subclinical Cerebral Edema in Diabetic Ketoacidosis by Magnetic Resonance Imaging T2 Relaxometry and Apparent Diffusion Coefficient Maps</title><title>Endocrine research</title><addtitle>Endocr Res</addtitle><description>Cerebral edema is the most significant complication in children with diabetic ketoacidosis (DKA). Our goal was to study whether subclinical cerebral edema was preferentially vasogenic or cytotoxic. Magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and T2 relaxometry (T2R)-were obtained in pediatric patients presenting with severe diabetic ketoacidosis (DKA) 6-12 hours after initial DKA treatment and stabilization and 96 hours after correction of DKA. T2 relaxometry was significantly increased during treatment in both white and gray matter, in comparison to the absolute T2R values 96 hours after correction of DKA (p = .034). Classic intracellular cytotoxic edema could not be detected, based on the lack of a statistically significant decrease in ADC values. ADC values were instead elevated, implying a large component of cell membrane water diffusion, correlating with the elevated white and gray matter T2R. We discuss the findings in relation to cerebral blood volume, cerebral vasoregulatory dysfunction, and cerebral hyperemia.</description><subject>Adolescent</subject><subject>Blood Chemical Analysis</subject><subject>Brain Edema - blood</subject><subject>Brain Edema - complications</subject><subject>Brain Edema - diagnosis</subject><subject>Cerebral edema</subject><subject>Cerebral hyperemia</subject><subject>Child</subject><subject>Diabetic ketoacidosis</subject><subject>Diabetic Ketoacidosis - blood</subject><subject>Diabetic Ketoacidosis - complications</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><issn>0743-5800</issn><issn>1532-4206</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctuFDEQRS0EIkPgA9ggr9g1-NEvCzbRECAiERIJa6vstieOuu3Gdgv6M_hjPMxICCGFle2qU1flexF6TskrSnrymnQ1b3pCGkLqhgrKHqANbTirakbah2iz71d74AQ9SemOEMoJ4Y_RCW1rzlnDN-jndV6GFQeLrxelR-edhhFvTTQqlsv5YCbAzuN3DpTJTuNPJgfQbgjJJaxWfAU7_7vxxaTgwWuDLybYOb_DN6wUR_gRJpPjisEP-GyeIRqfi561S3LB420w1jrt9tUrmNNT9MjCmMyz43mKvr4_v9l-rC4_f7jYnl1Wunw6V7SnltUKQLe2Bk1EpzutwJC2L28lbMe0UHwQfd8oIVotOsUaAUA1Z73u-Cl6edCdY_i2mJTl5JI24wjehCXJVhSL247_F6SiZUSQpoD0AOoYUorGyjm6CeIqKZH7wOQ_gZWZF0fxRU1m-DNxTKgAbw-A8zbECb6HOA4ywzqGaGPx2yXJ79N_89f4rYEx3-oSgrwLS_TF4Xu2-wWSvLc9</recordid><startdate>2005</startdate><enddate>2005</enddate><creator>Figueroa, Ramon E.</creator><creator>Hoffman, William H.</creator><creator>Momin, Zahir</creator><creator>Pancholy, Ajay</creator><creator>Passmore, Gregory G.</creator><creator>Allison, Jerry</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>2005</creationdate><title>Study of Subclinical Cerebral Edema in Diabetic Ketoacidosis by Magnetic Resonance Imaging T2 Relaxometry and Apparent Diffusion Coefficient Maps</title><author>Figueroa, Ramon E. ; Hoffman, William H. ; Momin, Zahir ; Pancholy, Ajay ; Passmore, Gregory G. ; Allison, Jerry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-181f24baac6f4ac097c7cbae068f4ab9f72c9b3d9885b996c97b259aa1c328c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Blood Chemical Analysis</topic><topic>Brain Edema - blood</topic><topic>Brain Edema - complications</topic><topic>Brain Edema - diagnosis</topic><topic>Cerebral edema</topic><topic>Cerebral hyperemia</topic><topic>Child</topic><topic>Diabetic ketoacidosis</topic><topic>Diabetic Ketoacidosis - blood</topic><topic>Diabetic Ketoacidosis - complications</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Figueroa, Ramon E.</creatorcontrib><creatorcontrib>Hoffman, William H.</creatorcontrib><creatorcontrib>Momin, Zahir</creatorcontrib><creatorcontrib>Pancholy, Ajay</creatorcontrib><creatorcontrib>Passmore, Gregory G.</creatorcontrib><creatorcontrib>Allison, Jerry</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Figueroa, Ramon E.</au><au>Hoffman, William H.</au><au>Momin, Zahir</au><au>Pancholy, Ajay</au><au>Passmore, Gregory G.</au><au>Allison, Jerry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Study of Subclinical Cerebral Edema in Diabetic Ketoacidosis by Magnetic Resonance Imaging T2 Relaxometry and Apparent Diffusion Coefficient Maps</atitle><jtitle>Endocrine research</jtitle><addtitle>Endocr Res</addtitle><date>2005</date><risdate>2005</risdate><volume>31</volume><issue>4</issue><spage>345</spage><epage>355</epage><pages>345-355</pages><issn>0743-5800</issn><eissn>1532-4206</eissn><abstract>Cerebral edema is the most significant complication in children with diabetic ketoacidosis (DKA). Our goal was to study whether subclinical cerebral edema was preferentially vasogenic or cytotoxic. Magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and T2 relaxometry (T2R)-were obtained in pediatric patients presenting with severe diabetic ketoacidosis (DKA) 6-12 hours after initial DKA treatment and stabilization and 96 hours after correction of DKA. T2 relaxometry was significantly increased during treatment in both white and gray matter, in comparison to the absolute T2R values 96 hours after correction of DKA (p = .034). Classic intracellular cytotoxic edema could not be detected, based on the lack of a statistically significant decrease in ADC values. ADC values were instead elevated, implying a large component of cell membrane water diffusion, correlating with the elevated white and gray matter T2R. We discuss the findings in relation to cerebral blood volume, cerebral vasoregulatory dysfunction, and cerebral hyperemia.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>16433253</pmid><doi>10.1080/07435800500451912</doi><tpages>11</tpages></addata></record> |
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| ispartof | Endocrine research, 2005, Vol.31 (4), p.345-355 |
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| source | MEDLINE; Taylor & Francis:Master (3349 titles); Taylor & Francis Medical Library - CRKN |
| subjects | Adolescent Blood Chemical Analysis Brain Edema - blood Brain Edema - complications Brain Edema - diagnosis Cerebral edema Cerebral hyperemia Child Diabetic ketoacidosis Diabetic Ketoacidosis - blood Diabetic Ketoacidosis - complications Humans Magnetic resonance imaging Magnetic Resonance Imaging - methods |
| title | Study of Subclinical Cerebral Edema in Diabetic Ketoacidosis by Magnetic Resonance Imaging T2 Relaxometry and Apparent Diffusion Coefficient Maps |
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