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FIG 1. Radiographic findings in a 12-year-old girl with a severe, reversible tacrolimus-related leukoencephalopathy.
A, Cerebral CT scan shows extensive subcortical hypoattenuation in both parietal regions (canthus-meatus plane, without contrast).
B, T1-weighted MR image obtained in the acute phase (day 1) shows no gadolinium enhancement or decreased signal intensity (5 mm slices, TR 760, TE 15/1, TA 03:42).
C–F, T2-weighted MR images obtained in the acute phase (day 1) show hyperintense lesions in the parietal white matter (C), periventricular white matter (D), cerebellum (E), and brainstem (F) (5 mm slices, TR 3100, TE 98/2, TA 04:03).
G–I, T2-weighted MR images obtained 18 days later (day 19), after a dose reduction of tacrolimus and stereotactic biopsy 6 days earlier, show a remarkable decrease in the hyperintense lesions in the parietal white matter (G). The hyperintense lesions in the cerebellar white matter and brain stem (H) have disappeared. Note the biopsy lesion (I) (5 mm slices, TR 3100, TE 98/2, TA 04:03).
J and K, T2-weighted MR images obtained 5 months after G–I show only a mild right-sided hyperintense lesion (J). In the left hemisphere, the biopsy lesion resides (K) (5 mm slices, TR 3100, TE 98/2, TA 04:03).
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