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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Leigh disease (subacute necrotizing encephalomyelopathy): CT and MR in five cases
C A Geyer1, K J Sartor, A J Prensky
1Department of Radiology, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.
Abstract:
Magnetic resonance (MR) imaging and CT were used in supporting the diagnosis of Leigh disease (subacute necrotizing encephalomyelopathy) in five patients. Two cases were confirmed at postmortem examination, and three patients have laboratory and/or clinical histories suggestive of Leigh disease. Four cases demonstrated findings in the basal ganglia, especially the putamina, with symmetrical areas of low attenuation on CT. Correspondingly, on proton saturation and T2-weighted pulse sequences, these areas showed high intensity signal characteristics by MR. Similar findings were noted in the caudate nucleus (two cases). Magnetic resonance proved to be superior to CT in establishing other areas of involvement: tectum and tegmentum (one case) and medullary olive (one case). Pathology identified these lesions as representing necrosis. Magnetic resonance may be diagnostic in the appropriate clinical setting.
Insights
Magnetic resonance (MR) imaging and CT scans aid in diagnosing Leigh disease, a rare neurological disorder. MR imaging offers superior detail in identifying affected brain regions compared to CT scans.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Leigh disease, also known as subacute necrotizing encephalomyelopathy, is a severe neurological disorder.
- Accurate and early diagnosis is crucial for patient management.
Purpose of the Study:
- To evaluate the utility of Magnetic Resonance (MR) imaging and Computed Tomography (CT) in diagnosing Leigh disease.
- To compare the effectiveness of MR imaging and CT in identifying characteristic brain lesions.
Main Methods:
- Retrospective analysis of five patients with suspected or confirmed Leigh disease.
- Review of MR imaging and CT scans, correlating findings with clinical and postmortem data.
Main Results:
- Symmetrical low attenuation in the basal ganglia (putamina) on CT correlated with high signal intensity on MR imaging.
- MR imaging identified additional affected areas, including the tectum, tegmentum, and medullary olive, which were not as clearly visualized by CT.
- Pathological examination confirmed necrotic lesions in the identified areas.
Conclusions:
- Both MR imaging and CT can support the diagnosis of Leigh disease.
- MR imaging demonstrates superior sensitivity in detecting the full extent of brain involvement in Leigh disease.
- In a relevant clinical context, MR imaging may be diagnostic for Leigh disease.
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