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(18)F-fluorodeoxyglucose positron emission tomography and MR imaging findings in Rasmussen encephalitis
D J Fiorella1, J M Provenzale, R E Coleman
1Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
AJNR. American Journal of Neuroradiology
|August 11, 2001
Summary
Rasmussen encephalitis shows unilateral brain hypometabolism on FDG PET and atrophy on MRI. Combining both imaging techniques improves diagnosis and hemisphere identification in this progressive neurological disorder.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Rasmussen encephalitis is a rare, progressive brain inflammation causing severe seizures in children.
- Diagnosis can be challenging due to its progressive nature and varied presentation.
Purpose of the Study:
- To characterize (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and MR imaging findings in Rasmussen encephalitis.
- To determine if combined imaging data are necessary for diagnosis and identifying the affected hemisphere.
Main Methods:
- Retrospective review of MR (10 patients) and FDG PET (11 patients) imaging data from 11 children with Rasmussen encephalitis.
- Conjoint analysis of imaging findings.
Main Results:
- MR imaging revealed predominantly unilateral cerebral atrophy in 9/10 patients, with increased T2 signal intensity in 9/10.
- FDG PET showed unilateral cerebral hypometabolism in all patients, correlating with atrophy.
- FDG PET also detected seizure activity foci (hypermetabolism) in 6 patients.
Conclusions:
- Rasmussen encephalitis is characterized by unilateral cerebral hypometabolism (FDG PET) and atrophy (MR imaging).
- While MR imaging often suggests the diagnosis, combining it with FDG PET enhances diagnostic confidence and clarifies hemisphere involvement, especially in subtle or bilateral cases.