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Serial diffusion-weighted imaging in MELAS.

T Ohshita¹, M Oka, Y Imon

¹Third Department of Internal Medicine, Hiroshima University School of Medicine, Japan. ohshitat@mcai.med.hiroshima-u.ac.jp

|November 9, 2000

Summary

Diffusion-weighted MRI in mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) reveals elevated apparent diffusion coefficient (ADC) in lesions, suggesting vasogenic edema and potential tissue recovery without severe damage.

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Area of Science:

Neurology
Radiology
Mitochondrial Diseases

Background:

Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) present with infarct-like brain lesions.
The precise pathogenesis of these lesions remains unclear.

Observation:

This study utilized diffusion-weighted imaging (DWI) MRI in two MELAS patients.
Apparent diffusion coefficient (ADC) was measured in acute and subacute infarct-like lesions.
Lesions showed high DWI signal and significantly elevated ADC compared to normal brain tissue.

Findings:

Elevated ADC persisted for at least 30 days post-episode, decreasing over time.
The initial ADC elevation is hypothesized to represent vasogenic edema.
Lesion ADC normalized with clinical improvement, indicating tissue recovery.

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Implications:

This is the first study to apply DWI in MELAS patients.
DWI and ADC mapping may offer insights into MELAS lesion pathogenesis and recovery.
Findings suggest a potential for reversible tissue changes in MELAS stroke-like episodes.