Cranial Magnetic Resonance Imaging Findings in Methanol Poisoning: Systematic Review and Meta-analysis of Radiological Prevalence
Vitoria Palazoni Viegas1, Rebeca Oliveira da Silva2, Bianca Nobre Aguirre3, Othon Trevisan Meira4, Pedro Lívio Gomes Moura5, Victor Arthur Ohannesian6, Cid Soares7, Beatriz Gonçalves da Silva Miroski Gerente8, Diogo Haddad Santos9
1Bascom Palmer Eye Institute, 2Federal University of Paraíba, 3Einstein Hospital Israelita, 4Institute of Neurology of Curitiba, 5Santa Maria University Center, 6Albert Einstein Israeli Faculty of Health Sciences, 7UniAtenas, 8University of Southern Santa Catarina, 9Federal University of São Paulo
Objective:
This meta-analysis aimed to evaluate the pooled prevalence of key cranial magnetic resonance imaging (MRI) findings in methanol poisoning, including putaminal necrosis, optic nerve injury, and mortality.
Background:
Methanol intoxication is a potentially fatal condition causing severe neurological deficits, yet the prevalence and clinical implications of MRI-detected brain lesions remain incompletely characterized.
Design/Methods:
A systematic review and meta-analysis were conducted following PRISMA 2020 and Cochrane Handbook guidelines. Eligible studies reporting MRI findings in patients with confirmed methanol poisoning were retrieved from Medline, Scopus, and Web of Science. A random-effects model was used to pool proportions, and heterogeneity was quantified using the I² statistic.
Results:
Fifteen studies encompassing 3–58 patients each were included (total n = 163). Patients were predominantly male, aged 17–77 years, with oral ingestion as the primary exposure route. Mortality was reported in 7 studies, with a pooled prevalence of 7.8% (95% CI 2.2–24.1; I² = 53.9%). Optic nerve injury was reported in 4 studies, with a pooled prevalence of 36.1% (95% CI 9.2–75.8; I² = 84.0%). Putaminal necrosis, the most frequent MRI finding, was reported in 8 studies, with a pooled prevalence of 47.6% (95% CI 30.3–65.6; I² = 75.0%).
Conclusions:
MRI abnormalities are highly prevalent in methanol poisoning. Putaminal necrosis represents the hallmark radiologic feature, while optic nerve injury is present in roughly one-third of cases. Despite moderate to high heterogeneity among studies, these findings reinforce MRI as a critical tool for assessing methanol-induced neurotoxicity and predicting clinical outcomes.
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