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Quantitative MR diffusion mapping and cyclosporine-induced neurotoxicity
S C Coley1, D A Porter, F Calamante
1Department of Neuroradiology, University College London Medical School, England.
AJNR. American Journal of Neuroradiology
|October 8, 1999
Summary
Cyclosporine neurotoxicity causes reversible fluid buildup in the brain, not acute ischemia. Apparent diffusion coefficient (ADC) mapping reveals increased diffusion in affected areas, which resolve over time.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Cyclosporine is an immunosuppressant medication with known potential neurological side effects.
- Neurotoxicity can manifest with various clinical and radiological findings.
Observation:
- Apparent diffusion coefficient (ADC) maps in two patients with cyclosporine-induced neurotoxicity displayed areas of increased diffusion.
- These diffusion changes correlated with signal abnormalities seen on T2-weighted MRI sequences.
Findings:
- The observed lesions on ADC maps were largely reversible, with no residual signal alterations after treatment.
- Increased diffusion suggests a reversible extravasation of fluid into the cerebral interstitium.
Implications:
- These findings indicate that cyclosporine neurotoxicity primarily involves reversible interstitial edema rather than acute ischemic injury.
- Diffusion-weighted imaging (DWI) and ADC mapping can help differentiate cyclosporine neurotoxicity from ischemic stroke.