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Assessing initial MRI reports for suspected CJD patients.

Aaron Jesuthasan1, Danielle Sequeira1,2, Harpreet Hyare3

  • 1NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, UK.

Journal of Neurology
|April 1, 2022
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Summary

Despite improvements, initial MRI scans for sporadic Creutzfeldt-Jakob disease (sCJD) still under-detect characteristic diffusion abnormalities. Increased reporting sensitivity is linked to cortical and multi-region signal changes, aiding earlier diagnosis.

Keywords:
CJDCreutzfeldt-Jakob diseaseMRIPrion

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Area of Science:

  • Neuroimaging
  • Neurology
  • Prion Diseases

Background:

  • MRI is crucial for diagnosing sporadic Creutzfeldt-Jakob disease (sCJD) by detecting diffusion abnormalities.
  • Previous studies indicated low sensitivity in reporting these MRI changes, delaying diagnosis.
  • This study re-evaluates MRI reporting sensitivity for sCJD a decade later.

Purpose of the Study:

  • To assess the current sensitivity of MRI reporting for sporadic Creutzfeldt-Jakob disease (sCJD).
  • To determine if MRI reporting sensitivity has improved over the past decade.
  • To identify factors influencing the detection of characteristic MRI abnormalities in sCJD.

Main Methods:

  • Reviewed initial MRI scans of 102 suspected sCJD patients (2015-2019).
  • Assessed for signal changes in the striatum, thalamus, and cortical ribbon.
  • Compared findings to formal reports and analyzed requesting indications and clinical data.

Main Results:

  • Characteristic MRI abnormalities were identified in 99% of cases.
  • Referring centers reported abnormalities in only 69% of cases, a significant improvement from 2012.
  • Reporting sensitivity increased with cortical involvement and multiple affected regions.

Conclusions:

  • Initial MRI reporting of sCJD has improved but remains suboptimal.
  • Characteristic abnormalities are frequently missed on initial scans.
  • Enhanced MRI awareness and sensitivity are vital for diagnosing rapidly progressive dementia.