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Diffusion-weighted MR imaging of posterior reversible leukoencephalopathy syndrome: a pictorial essay

Toshibumi Kinoshita1, Toshio Moritani, David A Shrier

  • 1Department of Radiology, Division of Radiology, University of Rochester Medical Center, 601 Elmwood Avenue Box 648, Rochester, NY 14642, USA. kino@grape.med.tottori-u.ac.jp

Clinical Imaging
|August 23, 2003
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) causes reversible white matter damage. Diffusion-weighted imaging helps distinguish reversible PRES from irreversible ischemic stroke, aiding in diagnosis and treatment.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition.
  • PRES typically involves reversible white matter lesions, but can lead to irreversible ischemic injury.
  • Accurate differentiation between reversible and irreversible lesions is crucial for patient management.

Purpose of the Study:

  • To illustrate the magnetic resonance (MR) imaging features of PRES.
  • To highlight the utility of diffusion-weighted imaging (DWI) in differentiating PRES from ischemic stroke.
  • To provide a pictorial essay for enhanced understanding of PRES imaging findings.

Main Methods:

  • Review of MR imaging studies in patients diagnosed with PRES.
  • Focus on characteristic imaging findings on various MR sequences.
  • Emphasis on DWI sequences for lesion characterization.

Main Results:

  • PRES demonstrates characteristic vasogenic edema, typically reversible.
  • Irreversible ischemic injury may coexist or mimic PRES.
  • DWI is critical in identifying restricted diffusion, indicative of ischemia.

Conclusions:

  • MR imaging, particularly DWI, is essential for diagnosing PRES.
  • DWI aids in distinguishing reversible vasogenic edema from irreversible cytotoxic edema in PRES.
  • Early recognition of irreversible injury can guide therapeutic decisions.

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