MR imaging of the central nervous system in diving-related decompression illness

Abstract

Purpose: This investigation was conducted to determine whether MR imaging showed cerebral or spinal damage in acute diving-related decompression illness, a term that includes decompression sickness (DCS) and arterial gas embolism (AGE)

Material and Methods: A total of 16 divers with dysbaric injuries were examined after the initiation of therapeutic recompression. Their injuries comprised: neurological DCS II n=8; AGE n=7; combined cerebral-AGE/spinal-DCS n=1. T1- and T2-weighted images of the brain were obtained in 2 planes. in addition, the spinal cord was imaged in 7 subjects. the imaging findings were correlated with the neurological symptoms

Results: MR images of the head showed ischemic cerebrovascular lesions in 6/8 patients with AGE but showed focal hyperintensities in only 2/8 divers with DCS. Spinalcord involvement was detected in 1/7 examinations, which was the combined cerebral-AGE/spinal-DCS case. There was agreement between the locations of the documented lesions and the clinical manifestations

Conclusion: MR readily detects cerebral damage in AGE but yields low sensitivity in DCS. A negative MR investigation cannot rule out AGE or DCS. However, MR is useful in the examination of patients with decompression illness