Literature DB >> 23993757

Atypical idiopathic inflammatory demyelinating lesions (IIDL): conventional and diffusion-weighted MR imaging (DWI) findings in 42 cases.

Claus Koelblinger1, Julia Fruehwald-Pallamar, Klaus Kubin, Mirja Wallner-Blazek, Luc van den Hauwe, Leonardo Macedo, Stefan B Puchner, Majda M Thurnher.   

Abstract

INTRODUCTION: The purpose of this study was to evaluate MR imaging characteristics with conventional and advanced MR imaging techniques in patients with IIDL.
METHODS: MR images of the brain in 42 patients (20 male, 22 female) with suspected or known multiple sclerosis (MS) from four institutions were retrospectively analyzed. Lesions were classified into five different subtypes: (1) ring-like lesions; (2) Balo-like lesions; (3) diffuse infiltrating lesions; (4) megacystic lesions; and (5) unclassified lesions. The location, size, margins, and signal intensities on T1WI, T2WI, and diffusion-weighted images (DWI), and the ADC values/ratios for all lesions, as well as the contrast enhancement pattern, and the presence of edema, were recorded.
RESULTS: There were 30 ring-like, 10 Balo-like, 3 megacystic-like and 16 diffuse infiltrating-like lesions were detected. Three lesions were categorized as unclassified lesions. Of the 30 ring-like lesions, 23 were hypointense centrally with a hyperintense rim. The mean ADC, measured centrally, was 1.50 ± 0.41 × 10(-3) mm(2)/s. The mean ADC in the non-enhancing layers of the Balo-like lesions was 2.29 ± 0.17 × 10(-3) mm(2)/s, and the mean ADC in enhancing layers was 1.03 ± 0.30 × 10(-3) mm(2)/s. Megacystic lesions had a mean ADC of 2.14 ± 0.26 × 10(-3)mm(2)/s. Peripheral strong enhancement with high signal on DWI was present in all diffuse infiltrating lesions. Unclassified lesions showed a mean ADC of 1.43 ± 0.13 mm(2)/s.
CONCLUSION: Restriction of diffusion will be seen in the outer layers of active inflammation/demyelination in Balo-like lesions, in the enhancing part of ring-like lesions, and at the periphery of infiltrative-type lesions.
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Entities:  

Keywords:  Atypical idiopathic inflammatory demyelinating lesions (IIDL); Diffusion-weighted MR imaging (DWI); Magnetic resonance imaging (MRI); Multiple sclerosis (MS)

Mesh:

Year:  2013        PMID: 23993757     DOI: 10.1016/j.ejrad.2013.07.026

Source DB:  PubMed          Journal:  Eur J Radiol        ISSN: 0720-048X            Impact factor:   3.528


  8 in total

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Journal:  J Neurol       Date:  2015-05-01       Impact factor: 4.849

2.  Clinical and Radiologic Features, Pathology, and Treatment of Baló Concentric Sclerosis.

Authors:  Evan A Jolliffe; Yong Guo; Todd A Hardy; P Pearse Morris; Eoin P Flanagan; Claudia F Lucchinetti; W Oliver Tobin
Journal:  Neurology       Date:  2021-05-19       Impact factor: 11.800

3.  Balo's Concentric Sclerosis with Acute Presentation and Co-Existing Multiple Sclerosis-Typical Lesions on MRI.

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Journal:  Case Rep Neurol       Date:  2015-02-28

4.  Chinese Guidelines for the Diagnosis and Management of Tumefactive Demyelinating Lesions of Central Nervous System.

Authors: 
Journal:  Chin Med J (Engl)       Date:  2017-08-05       Impact factor: 2.628

5.  High b-value diffusion-weighted imaging in progressive multifocal leukoencephalopathy in HIV patients.

Authors:  Claudia Godi; Enrico De Vita; Enrico Tombetti; Indran Davagnanam; Lewis Haddow; Hans Rolf Jäger
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6.  7 Tesla MRI of Balo's concentric sclerosis versus multiple sclerosis lesions.

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Review 7.  Clinical applications of diffusion-weighted sequence in brain imaging: beyond stroke.

Authors:  Siddhartha Gaddamanugu; Omid Shafaat; Houman Sotoudeh; Amir Hossein Sarrami; Ali Rezaei; Zahra Saadatpour; Aparna Singhal
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8.  Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis.

Authors:  Chung-Ping Lo; Hung-Wen Kao; Shao-Yuan Chen; Chi-Ming Chu; Chia-Chun Hsu; Ying-Chu Chen; Wei-Chen Lin; Dai-Wei Liu; Wen-Lin Hsu
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  8 in total

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