NR ATKK
AU Shiga,Y.; Sato,S.; Oikawa,T.; Shibuya,S.; Ogawa,T.; Itoyama,Y.
TI Usefulness of diffusion-weighted MRI for an early diagnosis of Creutzfeldt-Jakob disease
QU International Conference - Prion 2005: Between fundamentals and society's needs - 19.10.-21.10.2005, Congress Center Düsseldorf - Poster Session: Diagnosis DIA-22
PT Konferenz-Poster
AB Early and accurate diagnosis of Creutzfeldt-Jakob disease (CJD) is needed to start new therapeutic trials for the disease. However, it is not easy because the initial symptoms of CJD are variable. It has been reported that diffusion-weighted MRI (DWI) is useful for the early diagnosis. To clarify this issue we compared the patients' condition at the diagnosis estimated using the modified Rankin Scale (0: no symptoms at all; 1: no significant disability despite symptoms; 2: slight disability: able to look after own affairs without assistance; 3: moderate disability: requiring some help but able to walk without assistance; 4: moderately severe disability: unable to attend to own bodily needs or walk without assistance; 5: severe disability: bed ridden, incontinent, and requiring constant nursing care and attention) and the duration from the onset to the diagnosis between 24 CJD patients (68.4+/-7.4 years) diagnosed by conventional WHO criteria (Conventional group) and 14 CJD patients (67.1+/-8.3 years) diagnosed by a new criteria including positive DWI finding; progressive dementia, no pleocytosis in the CSF, slowing of the background activities without epileptic discharge in EEG, and high intensity lesion in the cortical ribbon, basal ganglia and/or thalamus (DWI group). No patients had family history of CJD. The duration from the onset to the diagnosis of Conventional group was 4.1+/-3.2 months and that of DWI group was 2.3+/-2.3 months (p<0.05). The modified Rankin Scale at the diagnosis of conventional group was 4.8+/-0.6 and that of DWI group was 2.6+/-0.7 (p<0.0001). Using the diagnostic criteria including DWI, patients were diagnosed earlier, and were therefore in a better condition. DWI can differentiate CJD from Alzheimer disease, dementia with Lewy body, and vascular dementia which are the three major differential diagnoses of sporadic CJD. We need to establish a new diagnostic criteria including DWI for an early clinical diagnosis of CJD.
AD Yusei Shiga, Yasuto Itoyama, Department of Neurology, Tohoku Unibersity School of Medicine; Shigeru Sato, Takanori Oikawa, Department of Neurology, Kohnan Hospital; Satoshi Shibuya, Department of Neurology, Miyagi National Hospital; Tatsuji Ogawa, Department of Neurology, Aoba Neurosurgical Clinic
SP englisch
PO Deutschland