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Neuro-Behcet’s Disease: Diffusion MR Imaging and Proton MR Spectroscopy

R. Nuri Senera

a From the Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey



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  		FIG 1. Images obtained during the acute stage.

A, Fluid-attenuated inversion recovery image reveals a left-sided hyperintense lesion in the pons.

B, T1-weighted image reveals a focal high signal intensity change, suggesting hemorrhage or presence of myelin breakdown products.

C, Contrast-enhanced T1-weighted image shows enhancement in the corresponding region.

D, Diffusion-weighted (b = 1000 s/mm2) image reveals high signal intensity in the lesion, suggesting restricted diffusion (see E).

E, ADC map (same section as that shown in D) reveals high signal intensity and a high ADC value (1.22 x 10-3 mm2/s), compared with the normal side of the pons (0.86 x 10-3 mm2/s) and compared with the temporal white matter (0.80 x 10-3 mm2/s). This is consistent with presence of increased diffusion, hence vasogenic edema.

F, Proton MR spectroscopy (1500/40) reveals that there is no lactic acid peak, excluding acute infarct. Major peaks are normal.



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  		FIG 2. Images obtained at the 16-month follow-up examination.

A, T2-weighted image reveals a small remaining focus of gliosis.

B, Diffusion-weighted (b = 1000 s/mm2) image is normal appearing.

C, ADC map (same section as that shown in B) reveals high signal intensity and a high ADC value (1.20 x 10-3 mm2/s), consistent with tissue disintegration due to gliosis.



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  		FIG 3. Fluid-attenuated inversion recovery image obtained at the 2-year follow-up examination reveals focal high signal intensity secondary to presumed gliosis.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X