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Updated: Aug 15, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Diffusion-weighted magnetic resonance imaging in early stage of 5-fluorouracil-induced leukoencephalopathy
1Department of Radiology, Hokkaido University School of Medicine, Kita-ku, Sapporo, Japan. khinkhintha@yahoo.co.uk
Abstract:
We report a case of 5-fluorouracil (5-FU)-induced leukoencephalopathy in which magnetic resonance imaging (MRI) of the brain, including diffusion-weighted imaging (DWI), was performed serially. The initial T2-weighted and FLAIR images showed diffuse mild hyperintensity in bilateral deep cerebral white matter and corpus callosum, which on T1WI appeared as non-enhanced faint hypointensity. Isotropic DWI disclosed the abnormality as well-conspicuous diffuse hyperintensity with decreased ADC. Serial studies revealed that majority of the abnormal signal intensity on these sequences resolved, and the decreased ADC values approached normal. Some hyperintensity remained in the deep cerebral white matter and the splenium, but no further significant ADC change after normalization was noted. Measurement of ADC along the three orthogonal directions showed the presence of directional dependence of diffusion throughout the length of study. These findings suggest that early stage of 5-FU-induced leukoencephalopathy is associated with reversible restricted diffusion and preservation of anisotropy. Diffusion-weighted imaging may be useful for the diagnosis.
Insights
5-fluorouracil (5-FU) chemotherapy can cause leukoencephalopathy, a reversible brain condition. Serial brain MRI with diffusion-weighted imaging (DWI) showed restricted diffusion that improved over time, aiding diagnosis.
Area of Science:
- Neuroimaging
- Neuroradiology
- Oncology
Background:
- 5-fluorouracil (5-FU) is a common chemotherapeutic agent.
- Leukoencephalopathy is a potential adverse effect of 5-FU treatment.
- Serial brain MRI, including diffusion-weighted imaging (DWI), is crucial for evaluating neurological complications.
Observation:
- Initial MRI revealed diffuse white matter hyperintensity in T2-weighted and FLAIR sequences.
- T1-weighted images showed non-enhanced hypointensity.
- Diffusion-weighted imaging (DWI) demonstrated conspicuous hyperintensity with decreased apparent diffusion coefficient (ADC), indicating restricted diffusion.
Findings:
- Serial MRI studies showed resolution of most abnormal signal intensities.
- Decreased ADC values approached normal levels over time.
- Some residual white matter hyperintensity persisted, but ADC values normalized.
- Diffusion-weighted imaging (DWI) revealed directional dependence of diffusion and preservation of anisotropy.
Implications:
- Early-stage 5-FU-induced leukoencephalopathy is characterized by reversible restricted diffusion.
- Diffusion-weighted imaging (DWI) is a valuable tool for diagnosing 5-FU-induced leukoencephalopathy.
- Preservation of anisotropy suggests the reversibility of white matter changes.
