Acute Acquired Metabolic Encephalopathy Based on Diffusion MRI: Note of an Error.

I read with interest the review article titled “Acute Acquired Metabolic Encephalopathy Based on Diffusion MRI” by Jeon et al. [1] in the December 2021 issue of the Korean Journal of Radiology. The authors supplied detailed information about the imaging features of acute acquired metabolic encephalopathies, and I obtained quite useful information from this article. I want to correct an error in Table 1 of the article.

Uremic encephalopathy is defined as cerebral dysfunction due to accumulation of toxins resulting from acute or chronic renal failure [2]. Magnetic resonance imaging (MRI) findings may be helpful in diagnosis when combined with laboratory and clinical findings. MRI may show abnormalities in the cortex, white matter, basal ganglia, and hippocampus. As described in the article, MRI findings in uremic encephalopathy are classified into three patterns: 1) cortical type, 2) basal ganglia type, and 3) diffuse white matter type [12]. The cortical type is the most common and is a part of the posterior reversible encephalopathy syndrome. The diffuse white matter type is rare. While the basal ganglia type is usually seen in diabetic uremic patients, the diffuse white matter type is observed in non-diabetic uremic patients. However, Table 1 indicates that the diffuse white matter type is seen in diabetic uremic patients and that the basal ganglia type is seen in non-diabetic uremic patients. This is a cause for misunderstanding.