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Diffusion MRI findings in isolated intracranial angiitis
1Department of Radiology, Ege University Hospital, Bornova, 35100 Izmir, Turkey. rnsener@hotmail.com
Summary
This study details a rare case of primary angiitis of the central nervous system in an 8-year-old girl. Diffusion MRI revealed multiple acute ischemic infarcts, confirmed by low apparent diffusion coefficient values.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Primary angiitis of the central nervous system (PACNS) is a rare inflammatory condition affecting blood vessels in the brain and spinal cord.
- Diagnosis can be challenging, especially in pediatric cases, often requiring advanced neuroimaging techniques.
Observation:
- An 8-year-old girl presented with symptoms suggestive of PACNS.
- Diffusion-weighted magnetic resonance imaging (dMRI) demonstrated multiple scattered lesions within the internal capsules, thalami, and left middle cerebellar peduncle.
- These lesions appeared hyperintense on b=1000s/mm(2) images.
Findings:
- Apparent diffusion coefficient (ADC) values for the acute lesions ranged from 0.40 to 0.52 x 10(-3)mm(2)/s, indicative of acute ischemic infarction due to cytotoxic edema.
- A chronic lesion in the left occipital region showed significantly higher ADC values (1.65–1.82 x 10(-3)mm(2)/s), consistent with established infarction.
Implications:
- This case highlights the utility of diffusion MRI in diagnosing acute ischemic changes in pediatric PACNS.
- Understanding dMRI characteristics, particularly ADC values, is crucial for differentiating acute from chronic infarcts in CNS vasculitis.
- Early and accurate diagnosis through advanced imaging can facilitate timely treatment and potentially improve outcomes for children with PACNS.