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Pattern of Cortical Changes in Sporadic Creutzfeldt-Jakob Disease

H.J. Tschampaa, K. Kallenbergc, H.A. Kretzschmard, B. Meissnerb, M. Knauthc, H. Urbacha and I. Zerrb

a Department of Radiology (Neuroradiology), Friedrich-Wilhelms University of Bonn, Germany
b Departments of Neurology, Georg-August University, Göttingen, Germany
c Departments of Neuroradiology, Georg-August University, Göttingen, Germany
d Department of Neuropathology, Ludwig-Maximilians University, Munich, Germany


Figure 1
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  		Fig 1. Modified section from a brain atlas20 showing the brain regions studied (right side) and the frequency (left side) in which cortical signal intensity abnormalities were detected. The gray-scale indicates the frequency in which the region shows hyperintensity, ranging from slight gray (postcentral gyrus, 28%) to dark gray (insula and superior frontal and cingulate gyri, 95%). [Reprinted with permission.]


Figure 2
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  		Fig 2. MR imaging scans of a 57-year-old patient with probable sporadic CJD 8 months after onset of disease. On DW MR imaging (A, C, E), there is hyperintensity in the striatum and insula (A), the superior and middle frontal gyri, and the precuneus (C), the superior and middle frontal gyri, the precuneus, and the paracentral lobe (E). On FLAIR (B, D), the insula and cingulate gyrus show increased signal intensity, whereas the hyperintense changes in the precuneus and paracentral lobe, easily identified on DW imaging (E), are questionable on FLAIR (F).


Figure 3
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  		Fig 3. DW (A, B) and FLAIR (C, D) MR imaging of a 63-year-old patient with definite sporadic CJD after 4 months of disease. There is extensive signal hyperintensity, including the cingulate gyrus (A–D), the frontal superior gyrus (A–D), occipital gyrus (A, C), the insula (A, C), the temporal medial gyrus (A, C), and the angular/supramarginal gyrus (B, D). The basal ganglia have normal signal intensity (A, C). The changes in signal intensity are easier to identify on DW (A, B) than on FLAIR imaging (C, D). (Images courtesy of H. Zeumer, Department of Neuroradiology, University Hospital Hamburg-Eppendorf, Germany.)





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X