Serial MR Imaging Findings of Acute Hemorrhagic Leukoencephalitis: A Case Report
Ho Yun Leea,
Kee-Hyun Changa,
Ji Hoon Kima,
Dong Gyu Naa,
Bae Ju Kwona,
Kwang-Woo Leeb and
Sung Hye Parkc
a Department of Radiology and Institute of Radiation Medicine, Seoul, Korea
b Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
c Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
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FIG 1. MR images obtained on admission.
A, Axial T2-weighted fast spin-echo image (TR/TE, 4390/121). B, Diffusion-weighted image (TR, 6500; b value, 1000 seconds/mm2). C, Apparent diffusion coefficient map. T2-weighted image (A) shows new large lesions mainly involving the bifrontal white matter and the genu of the corpus callosum. Diffusion-weighted image (B) and apparent diffusion coefficient map (C) reveal increased apparent diffusion coefficient in most of the lesions, with decreased apparent diffusion coefficient in the peripheral portions.
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FIG 2. Histopathologic microscopic finding obtained via stereotactic biopsy of right frontal lobe 26 days after admission. Microscopic photograph shows perivascular mononuclear inflammatory cell cuffing and diffuse infiltration of macrophages, with perivascular hemorrhages, which separate infiltration of macrophages (hematoxylin and eosin, original magnification x200).
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FIG 3. MR image obtained 102 days after admission. Contrast-enhanced axial T1-weighted spin-echo image (TR/TE, 650/17) shows residual cystic necrosis and cerebromalacia of the both frontal lobes.
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