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Diffusion- and perfusion-weighted MR imaging in a patient with acute demyelinating encephalomyelitis (ADEM)
Johannes Bernarding1, Jürgen Braun, Hans-Christian Koennecke
1Department of Medical Informatics, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Berlin, Germany. bernarding@ukbf.fu-berlin.de
Abstract:
To monitor changes of brain tissue metabolism in acute demyelinating encephalitis (ADEM), we examined a patient with suspected ADEM by serial MRI including diffusion- and perfusion-weighted imaging (DWI, PWI). Within the inflammatory tissue, the apparent diffusion coefficients were reduced, normal, and increased. Perfusion varied between reduced and normal values, except for small hyperperfused regions. Combining standard MRI with DWI and PWI may elucidate different overlapping phases in cerebral inflammation.
Insights
Serial MRI, including diffusion- and perfusion-weighted imaging (DWI, PWI), monitored brain metabolism changes in acute demyelinating encephalitis (ADEM). Findings reveal varied diffusion and perfusion within inflammatory tissue, suggesting overlapping inflammatory phases.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Acute demyelinating encephalitis (ADEM) is an inflammatory neurological disorder.
- Monitoring brain tissue metabolism is crucial for understanding ADEM progression.
- Standard MRI may not fully capture dynamic metabolic changes in ADEM.
Observation:
- A patient with suspected ADEM underwent serial MRI scans.
- Diffusion- and perfusion-weighted imaging (DWI, PWI) were utilized alongside standard MRI sequences.
- Apparent diffusion coefficients and perfusion values were analyzed within inflammatory brain tissue.
Findings:
- Within the inflammatory lesions of ADEM, apparent diffusion coefficients showed variable changes: reduced, normal, and increased.
- Cerebral perfusion demonstrated diverse patterns, predominantly reduced or normal, with occasional small hyperperfused areas.
- The study observed overlapping phases of cerebral inflammation through combined MRI techniques.
Implications:
- Combining standard MRI with DWI and PWI offers a more comprehensive assessment of ADEM.
- These advanced MRI techniques may help elucidate the distinct, overlapping phases of cerebral inflammation in ADEM.
- Serial DWI and PWI can provide valuable insights into brain tissue metabolism during acute inflammatory neurological conditions.