Abstract #2526

Recognition of Delayed Hypoxic Leukoencephalopathy after a Severe Drug Overdose Using a Divided Subtracted Inversion Recovery (dSIR) Sequence

Paul Condron^1,2, Gil Newburn¹, Maryam Tayebi^1,2, Eryn Kwon^1,2, Mark Griffin³, Miriam Scadeng^1,2, Samantha J Holdsworth^1,2, Daniel Cornfeld^1,2, and Graeme M Bydder^1,4

¹Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand, ²Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland, New Zealand, ³Insight Research Services Associated, Gold Coast, Australia, ⁴University of California, San Diego, San Diego, CA, United States

Synopsis

Keywords: White Matter, Drugs, tMRI, Delayed Hypoxic Leukoencephalopathy, Drug Overdose

Motivation: Divided Subtracted Inversion Recovery (dSIR) sequences can show subtle abnormalities due to small increases in T₁ that are not seen with conventional sequences,

Goal(s): To use dSIR sequences to examine the brain in a patient nine months after severe drug overdose associated with prolonged hypoxia and compare the dSIR images with T2-FLAIR images.

Approach: MRI scans obtained on an 18-y/o male control and a 19-y/o male patient. 2D IR FSE sequences were performed with TI_s chosen to null WM, and a longer TI_i producing dSIR images.

Results: Widespread abnormalities seen on dSIR images in areas of WM that appeared normal on T₂-FLAIR images.

Impact: In a patient imaged nine months after a severe drug overdose, dSIR images showed extensive abnormalities in white matter that appeared normal on T2-FLAIR images. Widespread white matter changes may be common unrecognised sequelae of severe drug overdoses.

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