Tags

Type your tag names separated by a space and hit enter

Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) on magnetic resonance imaging with fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging.
Acta Radiol. 2009 Apr; 50(3):334-9.AR

Abstract

BACKGROUND

Acute disseminated encephalomyelitis (ADEM) may be a rapidly progressive disease with different clinical outcomes.

PURPOSE

To investigate the radiological findings of fulminant ADEM on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images, and to correlate these findings with clinical outcome.

MATERIAL AND METHODS

Initial and follow-up magnetic resonance imaging (MRI) scans in eight patients were retrospectively evaluated for distribution of lesions on FLAIR images and presence of hemorrhage or contrast enhancement. DWI of the patients was evaluated as to cytotoxic versus vasogenic edema. The clinical records were analyzed, and MRI results and clinical outcome were correlated.

RESULTS

Four of the eight patients died, three had full recovery, and one had residual cortical blindness. The distribution of the hyperintense lesions on FLAIR sequence was as follows: frontal (37.5%), parietal (50%), temporal (37.5%), occipital (62.5%), basal ganglia (50%), pons (37.5%), mesencephalon (37.5%), and cerebellum (50%). Three of the patients who died had brainstem involvement. Two patients had a cytotoxic edema, one of whom died, and the other developed cortical blindness. Six patients had vasogenic edema: three of these patients had a rapid progression to coma and died; three of them recovered.

CONCLUSION

DWI is not always helpful for evaluating the evolution or predicting the outcome of ADEM. However, extension of the lesions, particularly brainstem involvement, may have an influence on the prognosis.

Authors+Show Affiliations

Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey. fuldemyildirim@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19235577

Citation

Donmez, F Y., et al. "Evaluation of Possible Prognostic Factors of Fulminant Acute Disseminated Encephalomyelitis (ADEM) On Magnetic Resonance Imaging With Fluid-attenuated Inversion Recovery (FLAIR) and Diffusion-weighted Imaging." Acta Radiologica (Stockholm, Sweden : 1987), vol. 50, no. 3, 2009, pp. 334-9.
Donmez FY, Aslan H, Coskun M. Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) on magnetic resonance imaging with fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging. Acta Radiol. 2009;50(3):334-9.
Donmez, F. Y., Aslan, H., & Coskun, M. (2009). Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) on magnetic resonance imaging with fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging. Acta Radiologica (Stockholm, Sweden : 1987), 50(3), 334-9. https://doi.org/10.1080/02841850902736617
Donmez FY, Aslan H, Coskun M. Evaluation of Possible Prognostic Factors of Fulminant Acute Disseminated Encephalomyelitis (ADEM) On Magnetic Resonance Imaging With Fluid-attenuated Inversion Recovery (FLAIR) and Diffusion-weighted Imaging. Acta Radiol. 2009;50(3):334-9. PubMed PMID: 19235577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) on magnetic resonance imaging with fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging. AU - Donmez,F Y, AU - Aslan,H, AU - Coskun,M, PY - 2009/2/25/entrez PY - 2009/2/25/pubmed PY - 2009/4/14/medline SP - 334 EP - 9 JF - Acta radiologica (Stockholm, Sweden : 1987) JO - Acta Radiol VL - 50 IS - 3 N2 - BACKGROUND: Acute disseminated encephalomyelitis (ADEM) may be a rapidly progressive disease with different clinical outcomes. PURPOSE: To investigate the radiological findings of fulminant ADEM on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images, and to correlate these findings with clinical outcome. MATERIAL AND METHODS: Initial and follow-up magnetic resonance imaging (MRI) scans in eight patients were retrospectively evaluated for distribution of lesions on FLAIR images and presence of hemorrhage or contrast enhancement. DWI of the patients was evaluated as to cytotoxic versus vasogenic edema. The clinical records were analyzed, and MRI results and clinical outcome were correlated. RESULTS: Four of the eight patients died, three had full recovery, and one had residual cortical blindness. The distribution of the hyperintense lesions on FLAIR sequence was as follows: frontal (37.5%), parietal (50%), temporal (37.5%), occipital (62.5%), basal ganglia (50%), pons (37.5%), mesencephalon (37.5%), and cerebellum (50%). Three of the patients who died had brainstem involvement. Two patients had a cytotoxic edema, one of whom died, and the other developed cortical blindness. Six patients had vasogenic edema: three of these patients had a rapid progression to coma and died; three of them recovered. CONCLUSION: DWI is not always helpful for evaluating the evolution or predicting the outcome of ADEM. However, extension of the lesions, particularly brainstem involvement, may have an influence on the prognosis. SN - 1600-0455 UR - https://www.unboundmedicine.com/medline/citation/19235577/Evaluation_of_possible_prognostic_factors_of_fulminant_acute_disseminated_encephalomyelitis__ADEM__on_magnetic_resonance_imaging_with_fluid_attenuated_inversion_recovery__FLAIR__and_diffusion_weighted_imaging_ L2 - http://journals.sagepub.com/doi/full/10.1080/02841850902736617?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -