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- Title
Atypical manifestations of reversible posterior leukoencephalopathy syndrome: findings on diffusion imaging and ADC mapping.
- Authors
Ahn, K. J.; You, W. J.; Jeong, S. L.; Lee, J. W.; Kim, B. S.; Lee, J. H.; Yang, D. W.; Son, Y. M.; Hahn, S. T.
- Abstract
Typically, reversible posterior leukoencephalopathy syndrome (RPLS) involves the parietooccipital lobes. When regions of the brain other than the parieto-occipital lobes arc predominantly involved, the syndrome can be called atypical RPLS. The purpose of this study is to find radiological and pathophysiological features of atypical RPLS by using diffusion-weighted imaging (D-WI). We retrospectively reviewed seven patients (two with eclampsia. one with cyclosporine neurotoxicity, and four with hypertensive encephalopathy) with atypical MR manifestations of RPLS. Changes in signal intensity on T2-weighted imaging (T2-WI) and D-WI, and ADC ratio, were analyzed. In patients with atypical manifestation of RPLS, high signal intensities on T2-WI were noted in the frontal lobe, basal ganglia, thalamus, brainstem, and subcortical white matter in regions other than the parieto-occipital lobes. These areas of increased signal intensities on T2-WI showed increased ADC values, representing vasogenic edema in all seven patients. This result should be very useful in differentiating atypical RPLS from other metabolic brain disorders that affect the same sites with cytotoxic edema.
- Subjects
AIDS dementia complex; CEREBRAL cortex; IMMUNOSUPPRESSIVE agents; MAGNETIC resonance imaging; DIAGNOSTIC imaging; BRAIN stem
- Publication
Neuroradiology, 2004, Vol 46, Issue 12, p978
- ISSN
0028-3940
- Publication type
Article
- DOI
10.1007/s00234-004-1276-1