The diffusion-weighted (DW) magnetic resonance (MR) imaging findings of a p
atient with subacute stage of heroin-induced vacuolating myelinopathy are r
eported. The diffuse decrease of apparent diffusion coefficient (ADC) of th
e white matter on DW imaging is attributed to restricted water diffusion, w
hich is known to be caused by fluid entrapment within the myelin lamellae w
ithout demyelination.