Thalamic involvement in sporadic Creutzfeldt-Jakob disease: a diffusion-weighted MR imaging study.

Full Abstract

BACKGROUND

AND PURPOSE:
Recent neuropathologic research suggests thalamic involvement in sporadic Creutzfeldt-Jakob disease (sCJD), which has been disregarded in imaging studies. Diffusion-weighted (DW) MR imaging has the highest sensitivity for the detection of signal intensity (SI) abnormalities in CJD. We hypothesized that pathologic changes in the thalamus in sCJD can be detected by using a subtle analysis of DW MR imaging.

METHODS:
Six sCJD patients and nine healthy controls were examined with a 1.5-T system by using DW single-shot spin-echo echo planar (b = 0, 1000 s/mm(2)), T2-weighted turbo spin-echo, and fluid-attenuated inversion recovery sequences. One patient was examined serially (3, 4, and 8 months after onset of symptoms). MR images were reviewed for SI changes in the striatum, hippocampus, mediodorsal thalamic nucleus (MD), and pulvinar thalami. Apparent diffusion coefficients (ADCs) were measured in these areas.

RESULTS:
All sCJD patients showed increased SI on DW images in the striatum bilaterally. ADCs in these areas were significantly reduced. Four of six sCJD patients showed increased SI on DW images in the pulvinar thalami, whereas ADCs were significantly reduced in all patients (mean ADC +/-

SEM:
in patients with SI changes, 701 +/- 38; in patients without SI changes, 684 +/- 37; in controls, 853 +/- 15 [P <.0001]). No patient showed SI changes in the MD on DW images, whereas ADCs were significantly reduced in all (664 +/- 28 as compared with 800 +/- 24 in controls [P =.0011]). Serial measurements in one sCJD patient showed ADC reduction in the pulvinar thalami preceding the SI changes on DW images.

CONCLUSION:
A quantitative analysis of DW images with ADC measurements shows slight MR imaging changes in the thalamus in sCJD when abnormal SI may not be present.

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Author information

Author/s: Tschampa, Henriette J (HJ); Mürtz, Petra (P); Flacke, Sebastian (S); Paus, Sebastian (S); Schild, Hans H (HH); Urbach, Horst (H);

Affiliation: Department of Radiology, University of Bonn, Germany.

Journal and publication information

Publication Type: Journal Article

Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol), published in United States. (Language: eng)

Reference: 2003-May; vol 24 (issue 5) : pp 908-15

Dates: Created 2003/05/15; Completed 2003/06/19; Revised 2008/10/31;

PMID: 12748093, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: AJNR Am J Neuroradiol. 2008 Aug;29(7):E57; author reply E58. (PMID: 18372408)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Caudate Nucleus - pathology
Creutzfeldt-Jakob Syndrome - diagnosis; pathology
Cross-Sectional Studies
Diffusion Magnetic Resonance Imaging
Female

Hippocampus - pathology
Humans
Male
Middle Aged
Putamen - pathology
Thalamus - pathology

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