Thalamic Involvement in Sporadic Creutzfeldt-Jakob Disease: A Diffusion-Weighted MR Imaging Study

Recent neuropathologic research suggests thalamic involvement in sporadic Creutzfeldt-Jakob disease (sCJD), which has been disregarded in imaging studies. Diffusion-weighted (DW) MR imaging has the highest sensitivity for the detection of signal intensity (SI) abnormalities in CJD. We hypothesized t...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2003-05, Vol.24 (5), p.908-915
Main Authors: Tschampa, Henriette J, Murtz, Petra, Flacke, Sebastian, Paus, Sebastian, Schild, Hans H, Urbach, Horst
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Brain
Caudate Nucleus - pathology
Creutzfeldt-Jakob Syndrome - diagnosis
Creutzfeldt-Jakob Syndrome - pathology
Cross-Sectional Studies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Diffusion Magnetic Resonance Imaging
Female
Hippocampus - pathology
Humans
Male
Medical sciences
Middle Aged
Neurology
Putamen - pathology
Thalamus - pathology
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Summary:Recent neuropathologic research suggests thalamic involvement in sporadic Creutzfeldt-Jakob disease (sCJD), which has been disregarded in imaging studies. Diffusion-weighted (DW) MR imaging has the highest sensitivity for the detection of signal intensity (SI) abnormalities in CJD. We hypothesized that pathologic changes in the thalamus in sCJD can be detected by using a subtle analysis of DW MR imaging. Six sCJD patients and nine healthy controls were examined with a 1.5-T system by using DW single-shot spin-echo echo planar (b = 0, 1000 s/mm(2)), T2-weighted turbo spin-echo, and fluid-attenuated inversion recovery sequences. One patient was examined serially (3, 4, and 8 months after onset of symptoms). MR images were reviewed for SI changes in the striatum, hippocampus, mediodorsal thalamic nucleus (MD), and pulvinar thalami. Apparent diffusion coefficients (ADCs) were measured in these areas. All sCJD patients showed increased SI on DW images in the striatum bilaterally. ADCs in these areas were significantly reduced. Four of six sCJD patients showed increased SI on DW images in the pulvinar thalami, whereas ADCs were significantly reduced in all patients (mean ADC +/- SEM: in patients with SI changes, 701 +/- 38; in patients without SI changes, 684 +/- 37; in controls, 853 +/- 15 [P
ISSN:0195-6108
1936-959X