PMID- 23304992
OWN - NLM
STAT- MEDLINE
DCOM- 20130131
LR  - 20191027
IS  - 0095-6562 (Print)
IS  - 0095-6562 (Linking)
VI  - 84
IP  - 1
DP  - 2013 Jan
TI  - Brain magnetic resonance imaging anomalies in U-2 pilots with neurological 
      decompression sickness.
PG  - 3-11
AB  - INTRODUCTION: This was a retrospective observational study of imaging used to 
      evaluate and treat 13 U-2 pilots with neurological decompression sickness (DCS). 
      Magnetic resonance imaging (MRI) and computed tomography (CT) provided data for 
      screening, diagnosis, and determinations of fitness to fly after recovery. While 
      small series and case reports described the role of imaging in diving DCS, none 
      addressed radiology's role in aviation DCS. METHODS: We performed a literature 
      review of altitude DCS radiology studies. We then reviewed radiology images at 
      our institution on U-2 pilots with neurological DCS between January 2002 and 
      August 2010. We retrospectively analyzed MRI data for white matter 
      hyper-intensities (WMHs), defined as hyperintense lesions > or = 3 mm on T2 and 
      FLAIR. All studies occurred after hyperbaric oxygen (HBO) treatment. RESULTS: 
      There were 17 pilots who reported 20 neurological DCS incidents. Of these 17 
      pilots, 13 underwent imaging. Two (15%) demonstrated acute subcortical lesions on 
      MRI, seven (54%) had asymptomatic WMHs, and six (46%) were normal. The clinical 
      significance of the lesions is unknown. Consistent with diving DCS, imaging 
      played no role in acute diagnosis. However, imaging was vital for determining 
      fitness for return to flying. Additionally, CT identified a potentially 
      predisposing sinus condition in one pilot which may enable return to flying after 
      treatment. CONCLUSIONS: Modern imaging has unique findings for altitude DCS 
      patients. The high incidence of WMHs in this series is a matter of ongoing 
      research to determine potential clinical consequences. Emerging techniques such 
      as functional MRI may play important roles in future aeromedical decisions.
FAU - Jersey, Sean L
AU  - Jersey SL
AD  - 60th Medical Group, Department of Radiology, David Grant USAF Medical Center, 101 
      Bodin Circle, Travis AFB, CA 94535, USA. sean.jersey@us.af.mil
FAU - Jesinger, Robert A
AU  - Jesinger RA
FAU - Palka, Peter
AU  - Palka P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Aviat Space Environ Med
JT  - Aviation, space, and environmental medicine
JID - 7501714
SB  - IM
CIN - Aviat Space Environ Med. 2013 Jul;84(7):746. PMID: 23855073
CIN - Aviat Space Environ Med. 2013 Jul;84(7):746. PMID: 23855074
MH  - Adult
MH  - *Aerospace Medicine
MH  - Brain/*pathology
MH  - Decompression Sickness/*pathology
MH  - Diffusion Tensor Imaging
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Military Personnel
MH  - Retrospective Studies
EDAT- 2013/01/12 06:00
MHDA- 2013/02/01 06:00
CRDT- 2013/01/12 06:00
PHST- 2013/01/12 06:00 [entrez]
PHST- 2013/01/12 06:00 [pubmed]
PHST- 2013/02/01 06:00 [medline]
AID - 10.3357/asem.3405.2013 [doi]
PST - ppublish
SO  - Aviat Space Environ Med. 2013 Jan;84(1):3-11. doi: 10.3357/asem.3405.2013.