The pulvinar sign on magnetic resonance imaging in variant Creutzfeldt-Jakob disease

There is a need for an accurate non-invasive diagnostic test for variant Creutzfeldt-Jakob disease (vCJD). We investigated the sensitivity and specificity of bilateral pulvinar high signal on magnetic resonance imaging (MRI) for the diagnosis of vCJD. MRI from patients with vCJD and controls (patien...

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Bibliographic Details
Published in:The Lancet (British edition) 2000-04, Vol.355 (9213), p.1412-1418
Main Authors: Zeidler, Martin, Sellar, Robin J, Collie, Donald A, Knight, Richard, Stewart, Gillian, Macleod, Margaret-Ann, Ironside, James W, Cousens, Simon, Colchester, Alan FC, Hadley, Donald M, Will, Robert G
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Atrophy - etiology
Biological and medical sciences
Brain - pathology
Case-Control Studies
Caudate Nucleus - pathology
Creutzfeldt-Jakob Syndrome - cerebrospinal fluid
Creutzfeldt-Jakob Syndrome - classification
Creutzfeldt-Jakob Syndrome - complications
Creutzfeldt-Jakob Syndrome - pathology
Disease Progression
Electroencephalography
False Positive Reactions
Humans
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging
Medical sciences
Middle Aged
Nervous system
Observer Variation
Putamen - pathology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Single-Blind Method
Thalamic Nuclei - pathology
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Summary:There is a need for an accurate non-invasive diagnostic test for variant Creutzfeldt-Jakob disease (vCJD). We investigated the sensitivity and specificity of bilateral pulvinar high signal on magnetic resonance imaging (MRI) for the diagnosis of vCJD. MRI from patients with vCJD and controls (patients with suspected CJD) were analysed. Scans were reviewed on two separate occasions by two neuroradiologists and scored for the distribution of changes, and likely final diagnosis. Scans from vCJD cases were reassessed to reach a consensus on all abnormalities. We analysed 36 patients and 57 controls. vCJD patients were correctly identified based on bilateral pulvinar high signal in 29 of 36 and 32 of 36 cases on the first assessment by the two radiologists, and 32 of 36 and 31 of 36 on their second assessment. Bilateral increased pulvinar signal was identified in one of 57 and one of 57 controls on the first assessment and two of 57 and three of 57 controls on the second assessment. These reported changes in controls were graded as minimal/equivocal in six of seven patients and moderate in one (
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(00)02140-1