Cranial magnetic resonance imaging findings in methanol poisoning: Systematic review and meta-analysis of radiological prevalence.
Rebeca Oliveira da Silva, Victor Arthur Ohannesian, Bianca Nobre Aguirre et al.
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In 30 seconds
This systematic review and meta-analysis assessed cranial MRI findings and in-hospital mortality among patients with confirmed methanol poisoning. Thirteen studies were included; pooled estimates drew on eight studies for putaminal necrosis, four for optic nerve injury, and seven for mortality. Putaminal necrosis was the most frequent MRI finding, with a pooled prevalence of 47.6% (95% CI 30.3-65.6; I 2 = 75.0%). Optic nerve injury prevalence was 36.1% (95% CI 9.2-75.8; I 2 = 84.0%), and pooled in-hospital mortality was 7.8% (95% CI 2.2-24.1; I 2 = 53.9%).
Key findings
- Putaminal necrosis had a pooled prevalence of 47.6% (95% CI 30.3-65.6; I 2 = 75.0%).
- Optic nerve injury had a pooled prevalence of 36.1% (95% CI 9.2-75.8; I 2 = 84.0%).
- Pooled in-hospital mortality was 7.8% (95% CI 2.2-24.1; I 2 = 53.9%).
Why it matters
The pooled estimates characterize the frequency of important MRI abnormalities in methanol poisoning, with putaminal necrosis the most commonly reported finding. This can help clinicians recognize the range of neurological injury described in affected patients. The substantial heterogeneity, particularly for optic nerve injury, means these prevalence estimates should be interpreted cautiously rather than assumed to apply uniformly across settings.
What to keep in mind
The estimates were based on a limited number of studies, and heterogeneity was substantial for MRI findings, including optic nerve injury (I 2 = 84.0%).