| Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement. | |
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MedLine Citation:
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PMID: 21979865 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively. METHODS: DWI within 24 h of onset of neurological symptoms. The apparent diffusion coefficient (ADC) was measured in grey/white matter and correlated with clinical and laboratory findings. RESULTS: DWI was abnormal in all. Abnormal ADC was detected in the supratentorial white matter (6/12) and cortex (1/12), the basal ganglia (5/12), the thalami (4/12), and the cerebellum (1/12). ADC was reduced in 5/12, increased in 4/12, and both in 3/12. Mean serum sodium was lower in patients with DWI abnormalities affecting the white matter (6/12), than in those with basal ganglia/thalamic involvement (6/12). Neurological outcome was normal in 4/11 and abnormal in 7/11, and 1 patient died, outcome did not correlate to either localisation or type of DWI abnormality. CONCLUSIONS: In D+HUS with neurological symptoms, early DWI may reveal abnormal ADC not only in the basal ganglia/thalami, but also in the white matter/cortex. Besides thrombotic microangiopathy, toxic effects of shiga toxin, azotaemia and hyponatraemia / hypoosmolality may be involved in cerebral involvement in children with D+HUS. Findings on early MRI seem not to predict clinical course or outcome. KEY POINTS : • DWI MR imaging may detect early CNS involvement in haemolytic uraemic syndrome • Different pathogenetical mechanisms may contribute to the CNS disease in HUS • Early MRI findings do not seem to allow prediction of clinical outcome. |
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Authors:
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Frank Donnerstag; Xiaoqi Ding; Lars Pape; Eva Bültmann; Thomas Lücke; Jan Zajaczek; Ludwig Hoy; Anibh Martin Das; Heinrich Lanfermann; Jochen Ehrich; Hans Hartmann |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-8 |
Journal Detail:
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Title: European radiology Volume: - ISSN: 1432-1084 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9114774 Medline TA: Eur Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute of Diagnostic and Therapeutic Neuroradiology, Hannover Medical School, 30623, Hannover, Germany, donnerstag.frank@mh-hannover.de. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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