NR AVFU
AU Kallenberg,K.; Schulz-Schaeffer,W.J.; Jastrow,U.; Poser,S.; Meissner,B.; Tschampa,H.J.; Zerr,I.; Knauth,M.
TI Creutzfeldt-Jakob disease: comparative analysis of MR imaging sequences.
QU AJNR. American Journal of Neuroradiology 2006 Aug; 27(7): 1459-62
PT journal article
AB 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.
MH Basal Ganglia/pathology; Caudate Nucleus/pathology; Cerebral Cortex/pathology; Comparative Study; Creutzfeldt-Jakob Syndrome/*diagnosis/pathology; Diffusion Magnetic Resonance Imaging/methods; Humans; Image Enhancement/methods; Magnetic Resonance Imaging/*methods; Putamen/pathology; Retrospective Studies; Sensitivity and Specificity; Thalamus/pathology
AD Department of Neuroradiology, Georg-August University Medical Center, Robert-Koch-Strasse 40, Göttingen 37075, Germany. kai.kallenberg@meduni-goettingen.de
SP englisch
PO USA