MR imaging of pseudotumor cerebri

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Idiopathic pseudotumor cerebri (IPT) is a condition affecting obese individuals, particularly young women.
• Previous research suggests increased brain water content in IPT patients.
• The precise mechanisms and imaging characteristics of brain edema in IPT require further elucidation.

Purpose of the Study:

• To investigate brain water content in obese women with IPT using advanced MRI techniques.
• To quantify potential increases in periventricular white matter edema.
• To correlate MRI findings with sodium imaging in a subset of patients.

Main Methods:

• High-field-strength (1.5 T) MRI including T2-weighted and balanced (proton density) sequences were performed on 11 obese women with IPT.
• A white matter water index was developed to assess signal changes in periventricular white matter.
• Comparison was made to an age-matched control group.
• Sodium MR imaging was conducted on five patients.

Main Results:

• The white matter water index was significantly higher in the IPT group (0.520 +/- 0.016) compared to controls (0.479 +/- 0.015), indicating increased white matter water signal.
• Two patients exhibited focal areas of increased signal in periventricular white matter, suggesting localized edema not detectable by CT.
• Sodium imaging corroborated the proton imaging findings in patients with focal abnormalities.

Conclusions:

• Obese patients with IPT exhibit a diffuse, low-level increase in brain white matter water content, consistent with mild edema.
• Advanced MRI techniques can detect subtle white matter changes in IPT.
• These findings support the hypothesis of increased brain water in idiopathic pseudotumor cerebri.