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Quantitative MRI shows cerebral microstructural damage in hemolytic–uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI

  • Diagnostic Neuroradiology
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Abstract

Introduction

Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic–uremic syndrome (STEC–HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI.

Methods

In nine patients with STEC–HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls.

Results

Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01).

Conclusion

Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic–toxic brain syndromes.

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Abbreviations

ADC:

Apparent diffusion coefficient

FA:

Fractional anisotropy

MRI:

Magnetic resonance imaging

PD:

Proton density

STEC:

Shiga toxin-producing E. coli

STEC–HUS:

Shiga toxin-producing E. coli infection associated hemolytic–uremic syndrome

Stx:

Shiga toxin

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Clinic for Neurology, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany

    Karin Weissenborn, Hans Worthmann & Meike Heeren

  2. Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany

    Eva Bültmann, Frank Donnerstag, Anja M. Giesemann, Friedrich Götz, Heinrich Lanfermann & Xiao-Qi Ding

  3. Clinic for Nephrology and Hypertension, Hannover Medical School, Hannover, Germany

    Jan Kielstein & Anke Schwarz

Authors
  1. Karin Weissenborn
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  2. Eva Bültmann
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  3. Frank Donnerstag
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  4. Anja M. Giesemann
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  5. Friedrich Götz
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  6. Hans Worthmann
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  7. Meike Heeren
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  8. Jan Kielstein
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  9. Anke Schwarz
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  10. Heinrich Lanfermann
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  11. Xiao-Qi Ding
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Correspondence to Karin Weissenborn.

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Weissenborn, K., Bültmann, E., Donnerstag, F. et al. Quantitative MRI shows cerebral microstructural damage in hemolytic–uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI. Neuroradiology 55, 819–825 (2013). https://doi.org/10.1007/s00234-013-1176-3

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  • DOI: https://doi.org/10.1007/s00234-013-1176-3

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