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FIG. 3. MR images in a patient (case 14), conditioned for transplantation with cyclophosphamide and busulfan, who presented with new-onset seizure 176 d after transplantation. The patient had grade 3 BMT-related TM that rapidly progressed to grade 4. The CsA level was in the normal therapeutic range. His baseline blood pressure was 160/90 mm Hg, which increased to 170/110 mm Hg at the time of toxic reaction. The initial CT scan showed only nonspecific areas of low attenuation in the parietal region. MR images were obtained 6 h after CT.
A–C, T2-weighted MR images from the midventricular level and high parietal region (2500/84/2) show extensive high-signal-intensity edema involving the cortex in the frontal and parietal regions bilaterally (arrowheads).
D and E, Contrast-enhanced images corresponding to B and C show bilateral punctate enhancement in the cortex of the frontal region (arrows). These areas of enhancement correspond to the regions of cortical signal abnormality noted in B and C.
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