Magnetic resonance imaging findings in cerebral fat embolism: Correlation with clinical manifestations

Objectives: Cerebral fat embolism (CFE) is a serious complication after fra cture of long bones. The mortality rate of CFE may be high, However, recent progress in treatment may decrease the mortality. We studied the validity of magnetic resonance imaging (MRI) to detect and grade severity of CFE in II patients with CFE. Methods: Glasgow Coma Scale score, Pao(2), Paco(2) at the onset, and minina l hemoglobin and platelet levels were monitored, and phagocytes in bronchoa lveolar lavage fluid were counted. Brain computed tomographic and MRI scans were performed serially, MRI findings were graded into four categories acc ording to the severity of T-2-weighted images. Results: High-intensity T-2 signals were identified in the various brain re gions as early as 4 hours after onset of CFE. The maximum MRI grade signifi cantly correlated with Glasgow Coma Scale score at the onset of CFE (p < 0. 01). High-intensity T-2 signal lesions fused and enlarged with time. In mos t cases, they diminished within 2 weeks. Three patients had persistent morb idity, Conclusion: MRI-T-2-weighted imaging seems to be the most sensitive imaging technique for diagnosing CFE, and correlates well with the clinical severi ty of brain Injury. With the aid of proper treatment for pulmonary fat embo lism, CFE is a potentially, reversible disease that can have a good outcome .