Neuroradiology of central pontine myelinolysis and its relationship to leukoencephalopathy

The clinical, radiologic, and neuropathologic findings in 12 patients with central pontine myelinolysis were analyzed. Head CT scans were available in seven patients and high-field-strength MR imaging studies were available in four. In eight cases, the diagnosis was confirmed at autopsy, with postmortem MR imaging being performed on cut sections in six. It has been suggested that MR imaging may be the imaging modality of choice in patients with central pontine myelinolysis. In an attempt to determine the specificity of the MR imaging findings in this entity, the authors reviewed over 220 cases with a radiologic diagnosis of leukoencephalopathy and an additional 50 cases of specific brainstem abnormalities (infarcts, gliomas, metastases, hematomas, and radiation-induced changes) drawn from over 3,000 1.5-T MR imaging examinations