NR ADWX
AU Featherstone,T.
TI Creutzfeldt-Jakob disease and bovine spongiform encephalopathy. Magnetic resonance imaging may have a role in diagnosing Creutzfeldt-Jakob disease.
QU British Medical Journal 1996 Jan 20; 312(7024): 180
KZ BMJ. 1995 Nov 25;311(7017):1415-21. PMID: 8520279
KI BMJ. 1996 Mar 30;312(7034):844. PMID: 8608302
PT comment; letter
VT
EDITOR, - Creutzfeldt-Jakob disease[i] is still rarely diagnosed in Britain, and neuropathological examination is required to confirm the diagnosis. Research in the United States, however, has shown the presence of bilaterally symmetric hyperintense abnormalities in the basal ganglia in T2 weighted magnetic resonance images in patients with pathologically proved Creutzfeldt-Jakob disease.[ii] This abnormality on magnetic resonance imaging was first reported in 1988.[iii] A colleague and I have reported Creutzfeldt-Jakob disease, with signal abnormalities in the basal ganglia on magnetic resonance imaging, in a 58 year old man with no occupational exposure to animals who presented with progressive dementia.[iv]
The prevalence of hyperintense abnormalities in the basal ganglia in T2 weighted images in patients with Creutzfeldt-Jakob disease has not been studied and remains unknown. Such hyperintense abnormalities in the basal ganglia can be seen in several disorders, but a combination of clinical features, laboratory findings, and imaging characteristics can be used to distinguish the other conditions from Creutzfeldt-Jakob disease. Although the absence of bilateral symmetric hyperintense lesions in the basal ganglia does not exclude Creutzfeldt-Jakob disease, it is reasonable to assume that their presence in patients with rapidly progressive dementia is a specific sign of the disease. It would be useful to know of other documented cases in which magnetic resonance imaging was carried out before death. Surely it would be worth while pursuing further research in this field and collating data from several centres with an interest in Creutzfeldt-Jakob disease to evaluate the role of magnetic resonance imaging in this condition.
TERENCE FEATHERSTONE Consultant radiologist
Department of Radiology Darlington Memorial Hospital Darlington DL3 6HX
i. Almond JW, Brown P, Gore SM, Hofman A, Wientjens DPWM, Ridley RM, et al. Will bovine spongiform encephalopathy transmit to humans? BMJ 1995;311:1415-21 (25 November.)
ii. Barboriak DP, Provenzale JM, Boyko OR MR diagnosis of Creutzfeldt-Jakob disease: significance of high signal intensity of the basal ganglia. AJR 1994:162:137-40.:
iii. Gertz HJ, Henkes H, Cervos-Navarro J. Creutzfeldt-Jakob disease: correlation of MRI and neuropathologic findings. Neurology 1988;38:1481-2.
iv. Featherstone T, Weerasinghe s. Creutzfeldt-Jakob disease MRI help in diagnosis? International Journal of Geriatric Psychiatry (in Press).
ZR 4
MH Creutzfeldt-Jakob Syndrome/*diagnosis; Human; *Magnetic Resonance Imaging; Male; Middle Age
SP englisch
PO England
OR Prion-Krankheiten 3