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Research ArticleBRAIN

Creutzfeldt-Jakob Disease: Comparative Analysis of MR Imaging Sequences

K. Kallenberg, W.J. Schulz-Schaeffer, U. Jastrow, S. Poser, B. Meissner, H.J. Tschampa, I. Zerr and M. Knauth
American Journal of Neuroradiology August 2006, 27 (7) 1459-1462;
K. Kallenberg
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W.J. Schulz-Schaeffer
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U. Jastrow
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S. Poser
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B. Meissner
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H.J. Tschampa
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I. Zerr
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M. Knauth
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Abstract

BACKGROUND AND PURPOSE: MR imaging has played an increasingly important role in the diagnosis of Creutzfeldt-Jakob disease (CJD) since basal ganglia abnormalities on T2-weighted images have been described; thus, the aim of our study was to compare the value of different MR images in the diagnosis of CJD.

METHODS: One hundred fifty-seven patients with CJD underwent MR imaging examinations. Ninety-two patients were neuropathologically confirmed, and 65 were clinically classified as having CJD through the CJD Surveillance Unit (probability of 95%). There was no standardized MR imaging protocol; thus, the examinations included 143 T2-weighted, 43 proton attenuation (PD)-weighted, 84 fluid-attenuated inversion recovery (FLAIR), and 44 diffusion-weighted images (DWI). The MR images were reviewed for pathologic changes of the basal ganglia, thalamus, and cerebral cortex.

RESULTS: Cortical abnormalities were present in 70 patients (45%) and were visible in 80% (35/44) of all available DWI examinations. The basal ganglia were affected in 94 patients (60%), in particular in the caudate nucleus; the most sensitive sequences were DWI (64%) and PD-weighted (63%). A thalamic involvement was more frequently diagnosed on PD-weighted images (19%) and DWI (14%) than on FLAIR or T2-weighted images.

CONCLUSION: PD-weighted images and DWI showed better results in the diagnosis of signal intensity changes in the basal ganglia compared with T2-weighted or FLAIR images; however, in the diagnosis of cortical changes, DWI was clearly superior. Our data suggest that DWI is the most sensitive MR imaging technique in the diagnosis of CJD.

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American Journal of Neuroradiology: 27 (7)
American Journal of Neuroradiology
Vol. 27, Issue 7
August 2006
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Creutzfeldt-Jakob Disease: Comparative Analysis of MR Imaging Sequences
K. Kallenberg, W.J. Schulz-Schaeffer, U. Jastrow, S. Poser, B. Meissner, H.J. Tschampa, I. Zerr, M. Knauth
American Journal of Neuroradiology Aug 2006, 27 (7) 1459-1462;

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Creutzfeldt-Jakob Disease: Comparative Analysis of MR Imaging Sequences
K. Kallenberg, W.J. Schulz-Schaeffer, U. Jastrow, S. Poser, B. Meissner, H.J. Tschampa, I. Zerr, M. Knauth
American Journal of Neuroradiology Aug 2006, 27 (7) 1459-1462;
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