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Updated: Aug 30, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Progressive multifocal leukoencephalopathy: diffusion-weighted imaging and pathological correlations
M Bergui1, G B Bradac, K K Oguz
1Department of Neuroradiology, University of Turin, Via Cherasco 15, 10126, Torino, Italy. mauro.bergui@unito.it
Abstract:
We examined MRI of two patients with progressive multifocal leukoencephalopathy (PML), including diffusion-weighted imaging (DWI), with calculation of apparent diffusion coefficients (ADC). The pathology findings of one patient were compared with those of MRI. The lesions had different ADC and DWI appearances, depending on the stage of the disease. Newer lesions and the advancing edge of large lesions had normal-to-low ADC and gave high signal on DWI. Older lesions and the centre of large lesions had increased ADC and gave low signal. High signal on DWI and low ADC mark the regions of active infection and cell swelling, distinguishing them from areas of reparative gliosis.
Insights
Diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADC) in MRI can differentiate active progressive multifocal leukoencephalopathy (PML) lesions from inactive ones. This helps distinguish active infection and cell swelling from reparative gliosis.
Area of Science:
- Neuroimaging
- Neuropathology
- Infectious Diseases
Background:
- Progressive multifocal leukoencephalopathy (PML) is a serious demyelinating disease.
- Accurate MRI assessment is crucial for diagnosis and management.
Observation:
- MRI including diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADC) was performed on two PML patients.
- Pathology findings of one patient were correlated with MRI.
Findings:
- Lesion appearance on DWI and ADC varied with disease stage.
- Active lesions showed normal-to-low ADC and high DWI signal.
- Inactive lesions demonstrated increased ADC and low DWI signal.
Implications:
- DWI and ADC can differentiate active PML from inactive or gliotic areas.
- This imaging distinction aids in understanding disease activity and progression.
- Potential for improved diagnostic accuracy and treatment monitoring in PML.
