Brain Magnetic Resonance Diffusion Abnormalities in Creutzfeldt-Jakob Disease

doi:10.1001/archneur.1997.00550230078021

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Vol. 54 No. 11, November 1997

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Brain Magnetic Resonance Diffusion Abnormalities in Creutzfeldt-Jakob Disease

Mark M. Bahn, MD, PhD; Daniel K. Kido, MD; Weili Lin, PhD; Alan L. Pearlman, MD

Arch Neurol. 1997;54(11):1411-1415.

Abstract

Background
Magnetic resonance imaging of the brain has been of limitedusefulness in the diagnosis of Creutzfeldt-Jakob disease. Abnormalitieson T₂-weighted images have been described, but these are neitherhighly sensitive nor specific.

Objective
To determine whether diffusion-weighted magnetic resonance imagesmight be useful in the evaluation of Creutzfeldt-Jakob disease.

Case Presentation
A 61-year-old woman with rapidly progressive dementia was referredfor cranial magnetic resonance imaging. Diffusion-weighted imageswere obtained as part of the examination. Brain biopsy confirmedthe diagnosis of Creutzfeldt-Jakob disease histologically.

Findings and Conclusions
The diffusion-weighted magnetic resonance brain images demonstratedbilaterally symmetrical marked increase in signal intensityin the caudate nuclei, putamina, thalami, cingulate gyri, andright inferior frontal cortex. The apparent diffusion coefficientmap showed abnormally low diffusion in these regions (as lowas 40% of normal in the caudate head). This suggests that thereis restricted diffusion in these regions. The T₂-weighted imagesdemonstrated slightly increased signal bilaterally in the caudatenuclei and putamina. These findings indicate that diffusionmagnetic resonance imaging might be a sensitive means of imagingthe abnormalities seen in Creutzfeldt-Jakob disease.

Author Affiliations

From the Neuroradiology Section (Drs Bahn and Kido) and the Division of Radiological Sciences of the Department of Radiology (Dr Lin), Mallinckrodt Institute of Radiology, and Department of Neurology (Dr Pearlman), Washington University School of Medicine, St Louis, Mo.

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