This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (82)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Prion Diseases  • Radiologic Imaging  • Magnetic Resonance Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

Mark M. Bahn, MD, PhD; Piero Parchi, MD

Arch Neurol. 1999;56:577-583.

Background  Traditional imaging methods, including computed tomography, routine magnetic resonance imaging (MRI), and magnetic resonance spectroscopy, have not been particularly useful in the diagnosis of Creutzfeldt-Jakob disease (CJD). Although abnormalities can be seen using these methods, the findings are evident only late in the disease or lack specificity or sensitivity.

Objective  To describe abnormalities on diffusion-weighted MRIs in 4 patients with proven CJD.

Methods  Diffusion-weighted MRIs were obtained on 4 patients with CJD as part of a routine MRI brain examination.

Results  In all 4 patients, diffusion-weighted MRIs of the brain demonstrated bilateral hyperintensity in the basal ganglia. In 1 patient, the most conspicuous abnormality seen in diffusion-weighted images was in the thalamus. Two patients also demonstrated hyperintensity in the cerebral cortex on diffusion-weighted images. Only 2 of 4 patients demonstrated clear abnormalities on routine (non–diffusion-weighted) MRIs. Diffusion abnormalities were visible in 1 patient within 1 month of symptom onset. The findings were most conspicuous and extensive in the patient with the longest duration of symptoms (7 months).

Conclusions  Diffusion-weighted MRI might provide a noninvasive method of identifying patients with CJD. However, further investigations must be performed to determine the specificity of these findings for CJD.

From the Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (Dr Bahn); and the Division of Neuropathology, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio (Dr Parchi).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 1999;56(5):634-636.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Magnetic resonance diagnostic markers in clinically sporadic prion disease: a combined brain magnetic resonance imaging and spectroscopy study
Lodi et al.
Brain 2009;132:2669-2679.
ABSTRACT | FULL TEXT  

Pathologic correlates of diffusion MRI changes in Creutzfeldt-Jakob disease
Manners et al.
Neurology 2009;72:1425-1431.
ABSTRACT | FULL TEXT  

MR Imaging of Familial Creutzfeldt-Jakob Disease: A Blinded and Controlled Study
Fulbright et al.
Am. J. Neuroradiol. 2008;29:1638-1643.
ABSTRACT | FULL TEXT  

Diffusion Tensor MR Imaging and Fiber Tractography: Theoretic Underpinnings
Mukherjee et al.
Am. J. Neuroradiol. 2008;29:632-641.
ABSTRACT | FULL TEXT  

In Vivo Detection of Thalamic Gliosis: A Pathoradiologic Demonstration in Familial Fatal Insomnia
Haik et al.
Arch Neurol 2008;65:545-549.
ABSTRACT | FULL TEXT  

Neuroimaging findings in human prion disease
Macfarlane et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:664-670.
ABSTRACT | FULL TEXT  

Pattern of Cortical Changes in Sporadic Creutzfeldt-Jakob Disease
Tschampa et al.
Am. J. Neuroradiol. 2007;28:1114-1118.
ABSTRACT | FULL TEXT  

Creutzfeldt-Jakob Disease Involvement of Rolandic Cortex: A Quantitative Apparent Diffusion Coefficient Evaluation
Lin et al.
Am. J. Neuroradiol. 2006;27:1755-1759.
ABSTRACT | FULL TEXT  

Creutzfeldt-Jakob Disease: Comparative Analysis of MR Imaging Sequences
Kallenberg et al.
Am. J. Neuroradiol. 2006;27:1459-1462.
ABSTRACT | FULL TEXT  

Childhood Onset in Familial Prion Disease With a Novel Mutation in the PRNP Gene.
Rogaeva et al.
Arch Neurol 2006;63:1016-1021.
ABSTRACT | FULL TEXT  

MRI in the diagnosis of sporadic Creutzfeldt-Jakob disease: a study on inter-observer agreement
Tschampa et al.
Brain 2005;128:2026-2033.
ABSTRACT | FULL TEXT  

Diffusion-Weighted and Fluid-Attenuated Inversion Recovery Imaging in Creutzfeldt-Jakob Disease: High Sensitivity and Specificity for Diagnosis
Young et al.
Am. J. Neuroradiol. 2005;26:1551-1562.
ABSTRACT | FULL TEXT  

Diffusion-Weighted Imaging of Acute Excitotoxic Brain Injury
Moritani et al.
Am. J. Neuroradiol. 2005;26:216-228.
FULL TEXT  

Serial Diffusion-Weighted MRI of Creutzfeldt-Jakob Disease
Ukisu et al.
Am. J. Roentgenol. 2005;184:560-566.
ABSTRACT | FULL TEXT  

Correlation Between Antemortem Magnetic Resonance Imaging Findings and Pathologically Confirmed Corticobasal Degeneration
Josephs et al.
Arch Neurol 2004;61:1881-1884.
ABSTRACT | FULL TEXT  

Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt-Jakob disease
Shiga et al.
Neurology 2004;63:443-449.
ABSTRACT | FULL TEXT  

Sporadic Creutzfeldt-Jakob disease: Magnetic resonance imaging and clinical findings
Meissner et al.
Neurology 2004;63:450-456.
ABSTRACT | FULL TEXT  

Spectroscopy and serial diffusion MR findings in hGH-Creutzfeldt-Jakob disease
Oppenheim et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:1066-1069.
ABSTRACT | FULL TEXT  

MRI characteristics of sporadic CJD with valine homozygosity at codon 129 of the prion protein gene and PrPSc type 2 in Japan
Fukushima et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:485-487.
ABSTRACT | FULL TEXT  

Thalamic Involvement in Sporadic Creutzfeldt-Jakob Disease: A Diffusion-Weighted MR Imaging Study
Tschampa et al.
Am. J. Neuroradiol. 2003;24:908-915.
ABSTRACT | FULL TEXT  

The Expanding Role of Imaging in Prion Disease
Taber et al.
J. Neuropsychiatry Clin. Neurosi. 2002;14:371-376.
FULL TEXT  

Emerging Patterns of Diffusion-Weighted MR Imaging in Creutzfeldt-Jakob Disease: Case Report and Review of the Literature
Mao-Draayer et al.
Am. J. Neuroradiol. 2002;23:550-556.
ABSTRACT | FULL TEXT  

Abnormal Diffusion-Weighted Magnetic Resonance Imaging in Creutzfeldt-Jakob Disease Following Corneal Transplantations
Rabinstein et al.
Arch Neurol 2002;59:637-639.
ABSTRACT | FULL TEXT  

Magnetic Resonance Imaging in the Clinical Diagnosis of Creutzfeldt-Jakob Disease
Schroter et al.
Arch Neurol 2000;57:1751-1757.
ABSTRACT | FULL TEXT  

Misleading results with the 14-3-3 assay for the diagnosis of Creutzfeldt-Jakob disease
Chapman et al.
Neurology 2000;55:1396-1398.
ABSTRACT | FULL TEXT  

14-3-3 testing in diagnosing Creutzfeldt-Jakob disease: A prospective study in 112 patients
Lemstra et al.
Neurology 2000;55:514-516.
ABSTRACT | FULL TEXT  

Progressive dementia and gait disorder in a 78 year old woman
Tagliati et al.
J. Neurol. Neurosurg. Psychiatry 2000;68:526-531.
FULL TEXT  

Differences between Gray Matter and White Matter Water Diffusion in Stroke: Diffusion-Tensor MR Imaging in 12 Patients
Mukherjee et al.
Radiology 2000;215:211-220.
ABSTRACT | FULL TEXT  

Clinicopathologic Case Report: Rapidly Progressive Dementia With Demyelinating Polyneuropathy
Bronstein et al.
J. Neuropsychiatry Clin. Neurosi. 1999;11:507-513.
ABSTRACT | FULL TEXT