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Diffusion-weighted MR imaging of neuro-Behçet's disease: a case report
Akio Hiwatashi1, Todd Garber, Toshio Moritani
1Department of Diagnostic Radiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642-8648, USA. Aiko_Hiwatashi@urmc.rochester.edu
Abstract:
We present a serial study of diffusion-weighted imaging (DWI) in a patient with neuro-Behçet's disease. Initial T2-weighted magnetic resonance images showed a hyperintense lesion in the brain stem. The lesion was slightly hyperintense on DWI and the apparent diffusion coefficient (ADC) was slightly increased. Ten months later, DWI showed an improvement in the abnormal signal intensity and the region of increased ADC had increased in size, especially on the left side. DWI is useful for differentiating an acute exacerbation of neuro-Behçet's disease from acute infarction.
Insights
Diffusion-weighted imaging (DWI) helps distinguish neuro-Behçet's disease flare-ups from strokes. Serial DWI scans showed lesion improvement over time, indicating its utility in monitoring this neurological condition.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Neuro-Behçet's disease is a rare inflammatory condition affecting the nervous system.
- Magnetic resonance imaging (MRI) is crucial for diagnosing neurological complications.
- Diffusion-weighted imaging (DWI) provides information about water molecule movement in tissues.
Observation:
- A patient with neuro-Behçet's disease underwent serial MRI scans.
- Initial T2-weighted images revealed a brainstem lesion.
- The lesion showed subtle hyperintensity on DWI with a slightly increased apparent diffusion coefficient (ADC).
Findings:
- Over ten months, DWI demonstrated improvement in the lesion's signal intensity.
- The area of increased ADC expanded, particularly on the left side.
- These changes suggest a dynamic process rather than acute infarction.
Implications:
- DWI is valuable for monitoring disease activity in neuro-Behçet's disease.
- Serial DWI can help differentiate active neuro-Behçet's lesions from ischemic stroke.
- This imaging technique aids in clinical management and treatment decisions.