Early- and Late-State Subacute Sclerosing Panencephalitis: Chemical Shift Imaging and Single-Voxel MR Spectroscopy
Alpay Alkana,
Kaya Saraca,
Ramazan Kutlua,
Cengiz Yakincib,
Ahmet Sigircia,
Mehmet Aslanb and
Tamer Baysala
a Departments of Radiology, Inonu University School of Medicine, Malatya, Turkey
b Pediatrics, Inonu University School of Medicine, Malatya, Turkey
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FIG 1. Findings in a 6-year-old girl with stage II SSPE.
A, Axial T2-weighted localizer image (2875/120) shows a 2 x 2 x 2-cm voxel placed in the left FSWM.
B, MR spectrum (single voxel, PRESS; 2000/31/256) shows a normal NAA/Cr ratio and increased Cho/Cr and MI/Cr ratios.
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FIG 2. Findings in an 8-year-old girl with stage II SSPE.
A, Axial T2-weighted image (4530/100) shows normal brain parenchymal findings.
B, Coronal T2-weighted localizer image (2875/120) shows a 2 x 2 x 2-cm voxel placed in the left POWM.
C, MR spectrum (single voxel, PRESS; 2000/31/256) shows a normal NAA/Cr ratio and increased Cho/Cr and MI/Cr ratios.
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FIG 3. Findings in an 8-year-old boy with stage III SSPE.
A, Coronal T2-weighted image (4530/100) shows periventricular hyperintensities and cerebral and brain stem atrophy.
B, Axial T2-weighted localizer image (2875/120) shows a 2 x 2 x 2-cm voxel placed in the left POWM.
C, MR spectrum (single voxel, PRESS; 2000/31/256) shows a substantially decreased NAA/Cr ratio, increased Cho/Cr, Ins/Cr ratios, and lipid and lactate peaks.
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FIG 4. Findings in a 7-year-old girl with stage III SSPE.
A, CSI map of NAA shows decreased NAA signal intensity in the FSWM (straight arrows) and POWM (curved arrows).
B, Axial T2-weighted localizer image (2875/120) for MVS shows periventricular hyperintensities and cerebral atrophy.
C, MR spectrum (1500/136) (1) shows a normal NAA/Cr ratio and increased Cho/Cr ratios in left periventricular white matter. MR spectrum (2) shows substantially decreased NAA/Cr and increased Cho/Cr ratios in the left POWM.
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FIG 5. Findings in an 8-year-old boy with stage III SSPE.
A, Coronal T2-weighted image (4530/100) shows periventricular hyperintensities and cerebral atrophy.
B, CSI map of Cho shows increased Cho signal intensity in the left periventricular white matter (arrows).
C, Axial T2-weighted localizer image (2875/120) for MVS shows diffuse periventricular hyperintensities and cerebral atrophy.
D, MR spectrum (1500/136) (3) shows significantly decreased NAA/Cr and increased Cho/Cr ratios in the left POWM.
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