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Clinical Article
Multimodal MRI manifestations of high altitude cerebral edema
LONG Changyou  BAO Haihua 

Cite this article as: LONG C Y, BAO H H. Multimodal MRI manifestations of high altitude cerebral edema[J]. Chin J Magn Reson Imaging, 2023, 14(2): 21-26, 55. DOI:10.12015/issn.1674-8034.2023.02.004.

[Abstract] Objective Based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), susceptibility weighted imaging (SWI) and apparent diffusion coefficient (ADC) value, the brain imaging manifestations of high-altitude cerebral edema (HACE) were comprehensively analyzed, and to explore its damage characteristics.Materials and Methods Thirty patients with HACE diagnosed from January 2012 to August 2022 were collected. The general clinical data of the patients were statistically analyzed and classified according to clinical symptoms. Then, all patients underwent multi-sequence (T1WI, T2WI, FLAIR, DWI) MRI examination, among which 9 patients also underwent SWI examination. Finally, the images were analyzed.Results (1) According to the clinical symptoms, 30 cases of HACE were divided into 12 mild cases and 18 severe cases. There was no significant difference in gender, age, leukocyte, neutrophil and glucose content between mild and severe HACE (all P>0.05). (2) The edema range of severe HACE in deep and juxtacortical white matter and corpus callosum was significantly larger than that of mild HACE, and the ADC value in the splenium of corpus callosum was significantly lower than that of mild HACE, and the above differences were statistically significant (P<0.001, P=0.001, P=0.049, respectively). (3) In mild and severe HACE, the signal intensity of DWI was significantly higher than that of conventional MRI sequences (T1WI, T2WI, FLAIR), and the difference was statistically significant (P=0.008, P=0.025, respectively). (4) In severe HACE, 7 cases had obvious bilateral thalamic level corticospinal tract edema (7/18, 38.9%), and SWI showed 5 cases with cerebral microbleeds (CMB), with the corpus callosum as the center (5/9, 55.6%).Conclusions DWI sequence has obvious advantages in the evaluation of HACE. The white matter injury in severe HACE is more severe and extensive than that in mild HACE, especially in corpus callosum, and some of them may also have CMBs and corticospinal tract edema.
[Keywords] high altitude;cerebral edema;cerebral microbleeds;magnetic resonance imaging;diffusion weighted imaging;apparent diffusion coefficient;susceptibility weighted imaging

LONG Changyou   BAO Haihua*  

Image Center, Affiliated Hospital of Qinghai University, Xining 810001, China

*Correspondence to: Bao HH, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Construction Project of Provincial Clinical Key Specialty of Qinghai Province.
Received  2022-08-16
Accepted  2023-02-03
DOI: 10.12015/issn.1674-8034.2023.02.004
Cite this article as: LONG C Y, BAO H H. Multimodal MRI manifestations of high altitude cerebral edema[J]. Chin J Magn Reson Imaging, 2023, 14(2): 21-26, 55. DOI:10.12015/issn.1674-8034.2023.02.004.

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