Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Murata, T. Articles by Mugikura, S. Search for Related Content PubMed PubMed Citation Articles by Murata, T. Articles by Mugikura, S.

American Journal of Neuroradiology 23:1164-1172, August 2002
© 2002 American Society of Neuroradiology

BRAIN

Conspicuity and Evolution of Lesions in Creutzfeldt-Jakob Disease at Diffusion-Weighted Imaging

Takaki Murata^a, Yusei Shiga^b, Shuichi Higano^a, Shoki Takahashi^a and Shunji Mugikura^a

^a Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Japan
^b Neurology, Tohoku University School of Medicine, Sendai, Japan

Address reprint requests to Takaki Murata, MD, Department of Diagnostic Tadiology, Tohoku University School of Medicine, 1–1 Seiryou-machi Aoba-ku Sendai Japan 980-8574

BACKGROUND AND PURPOSE: Diffusion-weighted imaging can disclose distinct hyperintense lesions in Creutzfeldt-Jakob disease (CJD). However, these findings and chronologic changes of CJD at diffusion-weighted imaging have not been fully investigated. Our purpose was to assess the diagnostic value of diffusion-weighted imaging in depicting CJD-related lesions and in tracking the evolution of these lesions. We also compared the sensitivity of diffusion-weighted imaging in depicting CJD-related lesions to that of fluid-attenuated inversion recovery (FLAIR) imaging.

METHODS: We reviewed findings in 13 patients with a diagnosis of CJD who underwent MR imaging, including diffusion-weighted imaging. Nine patients were initially examined within 4 months of onset of symptoms (early stage), and eight were examined 4 months or later (late stage). We evaluated four items: 1) distribution of lesions at diffusion-weighted imaging, 2) conspicuity of lesions at diffusion-weighted imaging and FLAIR imaging, 3) chronologic changes in lesions at diffusion-weighted imaging, and 4) chronologic changes in lesions revealed by apparent diffusion coefficient (ADC) maps.

RESULTS: Patients had striatal lesions or cerebral cortical lesions or both. The thalamus was involved in only one patient, and the globus pallidus was spared in all patients. The sensitivity of diffusion-weighted imaging in depicting lesions was superior or at least equal to that of FLAIR imaging. Hyperintense lesions at diffusion-weighted imaging changed in extent and intensity over time. Unlike infarction, lesional ADC decreased for 2 weeks or longer.

CONCLUSION: The progressively hyperintense changes in the striata and cerebral cortices at diffusion-weighted imaging are considered characteristic of CJD. Diffusion-weighted imaging may be useful for the early diagnosis of CJD.

This article has been cited by other articles:

				D. N. Manners, P. Parchi, C. Tonon, S. Capellari, R. Strammiello, C. Testa, G. Tani, E. Malucelli, C. Spagnolo, P. Cortelli, et al. Pathologic correlates of diffusion MRI changes in Creutzfeldt-Jakob disease Neurology, April 21, 2009; 72(16): 1425 - 1431. [Abstract] [Full Text] [PDF]

				R.K. Fulbright, C. Hoffmann, H. Lee, A. Pozamantir, J. Chapman, and I. Prohovnik MR Imaging of Familial Creutzfeldt-Jakob Disease: A Blinded and Controlled Study AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1638 - 1643. [Abstract] [Full Text] [PDF]

				P. Brown Transmissible spongiform encephalopathy in the 21st century: Neuroscience for the clinical neurologist Neurology, February 26, 2008; 70(9): 713 - 722. [Full Text] [PDF]

				R. Ukisu, T. Kushihashi, E. Tanaka, M. Baba, N. Usui, H. Fujisawa, and H. Takenaka Diffusion-weighted MR Imaging of Early-Stage Creutzfeldt-Jakob Disease: Typical and Atypical Manifestations1 RadioGraphics, October 1, 2006; 26(suppl_1): S191 - S204. [Abstract] [Full Text] [PDF]

				Y.-R. Lin, G.S. Young, N.-K. Chen, W.P. Dillon, and S. Wong Creutzfeldt-Jakob Disease Involvement of Rolandic Cortex: A Quantitative Apparent Diffusion Coefficient Evaluation AJNR Am. J. Neuroradiol., September 1, 2006; 27(8): 1755 - 1759. [Abstract] [Full Text] [PDF]

				I. Sibon, A. Foubert, P. Menegon, F. Yekhlef, V. Dousset, and J. M. Orgogozo Creutzfeldt-Jakob disease mimicking radiologic posterior reversible leukoencephalopathy Neurology, July 26, 2005; 65(2): 329 - 329. [Full Text] [PDF]

				G. S. Young, M. D. Geschwind, N. J. Fischbein, J. L. Martindale, R. G. Henry, S. Liu, Y. Lu, S. Wong, H. Liu, B. L. Miller, et al. Diffusion-Weighted and Fluid-Attenuated Inversion Recovery Imaging in Creutzfeldt-Jakob Disease: High Sensitivity and Specificity for Diagnosis AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1551 - 1562. [Abstract] [Full Text] [PDF]

				T. Moritani, W. R. K. Smoker, Y. Sato, Y. Numaguchi, and P.-L. A. Westesson Diffusion-Weighted Imaging of Acute Excitotoxic Brain Injury AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 216 - 228. [Full Text] [PDF]

				R. Ukisu, T. Kushihashi, T. Kitanosono, H. Fujisawa, H. Takenaka, Y. Ohgiya, T. Gokan, and H. Munechika Serial Diffusion-Weighted MRI of Creutzfeldt-Jakob Disease Am. J. Roentgenol., February 1, 2005; 184(2): 560 - 566. [Abstract] [Full Text] [PDF]

				Y. Shiga, K. Miyazawa, S. Sato, R. Fukushima, S. Shibuya, Y. Sato, H. Konno, K. Doh-ura, S. Mugikura, H. Tamura, et al. Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt-Jakob disease Neurology, August 10, 2004; 63(3): 443 - 449. [Abstract] [Full Text] [PDF]

				C Oppenheim, M Zuber, D Galanaud, M Detilleux, F Bolgert, J L Mas, J Chiras, and J F Meder Spectroscopy and serial diffusion MR findings in hGH-Creutzfeldt-Jakob disease J. Neurol. Neurosurg. Psychiatry, July 1, 2004; 75(7): 1066 - 1069. [Abstract] [Full Text] [PDF]

				K. Ishikawa, K. Doh-ura, Y. Kudo, N. Nishida, I. Murakami-Kubo, Y. Ando, T. Sawada, and T. Iwaki Amyloid imaging probes are useful for detection of prion plaques and treatment of transmissible spongiform encephalopathies J. Gen. Virol., June 1, 2004; 85(6): 1785 - 1790. [Abstract] [Full Text] [PDF]

				K. Jin, Y. Shiga, S. Shibuya, K. Chida, Y. Sato, H. Konno, K. Doh-ura, T. Kitamoto, and Y. Itoyama Clinical features of Creutzfeldt-Jakob disease with V180I mutation Neurology, February 10, 2004; 62(3): 502 - 505. [Abstract] [Full Text] [PDF]

				H. J. Tschampa, P. Murtz, S. Flacke, S. Paus, H. H. Schild, and H. Urbach Thalamic Involvement in Sporadic Creutzfeldt-Jakob Disease: A Diffusion-Weighted MR Imaging Study AJNR Am. J. Neuroradiol., May 1, 2003; 24(5): 908 - 915. [Abstract] [Full Text] [PDF]

				C. A. Rentz Creutzfeldt-Jakob disease: Two case studies American Journal of Alzheimer's Disease and Other Dementias, May 1, 2003; 18(3): 171 - 180. [Abstract] [PDF]

				C. HAYWARD, B. H. FLORES, H. B. SOLVASON, P. ZEIFERT, and B. T. HARRIS Dr. Hayward and Colleagues Reply Am J Psychiatry, February 1, 2003; 160(2): 391 - 392. [Full Text] [PDF]