Document Detail


Acute multiple sclerosis lesion: conversion of restricted diffusion due to vasogenic edema.
MedLine Citation:
PMID:  19888931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is widely accepted that acute demyelinating plaques in patients with multiple sclerosis (MS) demonstrate increased apparent diffusion coefficient (ADC) and increased diffusion weighted imaging (DWI) signals on MRI. These imaging characteristics in acute MS lesions have been postulated to be due to peripheral vasogenic edema that typically increases the ADC. This assumption is commonly used to differentiate stroke from MS lesions since acute and subacute stroke lesions demonstrate increased DWI signal with reduced ADC due to acute cytotoxic edema. We report a case of active relapsing-remitting MS with two new symptomatic contrast-enhancing lesions. The lesions had reduced diffusion on the ADC map in the early acute phase of MS exacerbation. The reduced ADC signal was subsequently "converted" to increased ADC signal that coincided with the development of profound peripheral vasogenic edema seen on T2-weighted images. To our knowledge, this is the first serial MRI study describing decreased ADC signal in the early acute phase of contrast-enhancing MS lesion. The implications of decreased diffusion in the acute phase of MS lesions for the disease pathogenesis are discussed.
Authors:
Konstantin E Balashov; Latt Latt Aung; Suhayl Dhib-Jalbut; Irwin A Keller
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  21     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-25     Completed Date:  2011-07-26     Revised Date:  2012-04-04    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  202-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 by the American Society of Neuroimaging.
Affiliation:
Department of Neurology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA. kbalashov@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Brain Edema / diagnosis*,  etiology
Contrast Media / diagnostic use
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging / methods*
Multiple Sclerosis / complications,  diagnosis*
Young Adult
Grant Support
ID/Acronym/Agency:
K23 NS052553-03/NS/NINDS NIH HHS; K23NS052553/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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