Acute disseminated encephalomyelitis MRI: Difference between revisions
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==MRI== | ==MRI== | ||
[[MRI]] is the best method for further evaluation after an initial suspicion of [[ADEM]]. [[MRI]] brain with [[gadolinium]] [[enhancement]] is indicated in stable [[patients]] whereas, [[MRI]] of the [[dorsal]] and [[cervical]] [[spinal cord]] can determine the [[extent]] of [[inflammation]] in [[symptoms]] and [[signs]] suggestive of [[myelopathy]]<ref name="pmid19038851">{{cite journal| author=Callen DJ, Shroff MM, Branson HM, Li DK, Lotze T, Stephens D | display-authors=etal| title=Role of MRI in the differentiation of ADEM from MS in children. | journal=Neurology | year= 2009 | volume= 72 | issue= 11 | pages= 968-73 | pmid=19038851 | doi=10.1212/01.wnl.0000338630.20412.45 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038851 }} </ref>. | [[MRI]] is the best method for further evaluation after an initial suspicion of [[ADEM]]. [[MRI]] brain with [[gadolinium]] [[enhancement]] is indicated in stable [[patients]] whereas, [[MRI]] of the [[dorsal]] and [[cervical]] [[spinal cord]] can determine the [[extent]] of [[inflammation]] in [[symptoms]] and [[signs]] suggestive of [[myelopathy]]<ref name="pmid19038851">{{cite journal| author=Callen DJ, Shroff MM, Branson HM, Li DK, Lotze T, Stephens D | display-authors=etal| title=Role of MRI in the differentiation of ADEM from MS in children. | journal=Neurology | year= 2009 | volume= 72 | issue= 11 | pages= 968-73 | pmid=19038851 | doi=10.1212/01.wnl.0000338630.20412.45 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038851 }} </ref>. Despite the absence of specific criteria, especially for children<ref name="pmid15289266">{{cite journal| author=Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C | display-authors=etal| title=MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. | journal=Brain | year= 2004 | volume= 127 | issue= Pt 9 | pages= 1942-7 | pmid=15289266 | doi=10.1093/brain/awh218 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15289266 }} </ref>, follow up [[MRI]] scans at intervals no lesser than six months help establish or confirm the [[diagnosis]] of [[ADEM]]. The [[lesions]] should resolve or remain unchanged<ref name="pmid2328406">{{cite journal| author=Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D | display-authors=etal| title=Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. | journal=Brain | year= 1990 | volume= 113 ( Pt 2) | issue= | pages= 291-302 | pmid=2328406 | doi=10.1093/brain/113.2.291 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2328406 }} </ref>. | ||
===[[Lesion]] features=== | |||
*[[T2-weighted]] and [[fluid-attenuated]] [[inversion]] [[recovery]] [[sequences]] typically demonstrate [[multifocal]], [[hyperintense]] [[lesions]], which vary from small, round/ovoid [[foci]] to [[flocculent]], "cotton-ball"[[lesions]] with fuzzy [[margins]] | |||
*It can involve both [[white matter]] (WM) and [[gray matter]](GM), involvement of the former being typically [[bilateral]] and [[asymmetric]] | |||
*Abnormalities are found in the [[subcortical]] and [[central]] WM, [[cortical]] GM-WM [[junction]] and deep [[GM]] of [[brainstem]], [[cerebellar]] [[thalami]] and [[basal ganglia]]. | |||
==References== | ==References== | ||
Revision as of 10:21, 18 November 2022
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Acute disseminated encephalomyelitis Microchapters |
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Differentiating Acute disseminated encephalomyelitis from other Diseases |
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Diagnosis |
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Acute disseminated encephalomyelitis MRI On the Web |
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American Roentgen Ray Society Images of Acute disseminated encephalomyelitis MRI |
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Directions to Hospitals Treating Acute disseminated encephalomyelitis |
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Risk calculators and risk factors for Acute disseminated encephalomyelitis MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
MRI
MRI is the best method for further evaluation after an initial suspicion of ADEM. MRI brain with gadolinium enhancement is indicated in stable patients whereas, MRI of the dorsal and cervical spinal cord can determine the extent of inflammation in symptoms and signs suggestive of myelopathy[1]. Despite the absence of specific criteria, especially for children[2], follow up MRI scans at intervals no lesser than six months help establish or confirm the diagnosis of ADEM. The lesions should resolve or remain unchanged[3].
Lesion features
- T2-weighted and fluid-attenuated inversion recovery sequences typically demonstrate multifocal, hyperintense lesions, which vary from small, round/ovoid foci to flocculent, "cotton-ball"lesions with fuzzy margins
- It can involve both white matter (WM) and gray matter(GM), involvement of the former being typically bilateral and asymmetric
- Abnormalities are found in the subcortical and central WM, cortical GM-WM junction and deep GM of brainstem, cerebellar thalami and basal ganglia.
References
- ↑ Callen DJ, Shroff MM, Branson HM, Li DK, Lotze T, Stephens D; et al. (2009). "Role of MRI in the differentiation of ADEM from MS in children". Neurology. 72 (11): 968–73. doi:10.1212/01.wnl.0000338630.20412.45. PMID 19038851.
- ↑ Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C; et al. (2004). "MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood". Brain. 127 (Pt 9): 1942–7. doi:10.1093/brain/awh218. PMID 15289266.
- ↑ Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D; et al. (1990). "Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis". Brain. 113 ( Pt 2): 291–302. doi:10.1093/brain/113.2.291. PMID 2328406.