Acute disseminated encephalomyelitis MRI: Difference between revisions
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==MRI== | ==MRI== | ||
[[MRI]] is the best method for further evaluation after an initial suspicion of [[ADEM]]. [[MRI]] brain with [[gadolinium]] [[enhancement]] is indicated in stable [[patients]] whereas, [[MRI]] of the [[dorsal]] and [[cervical]] [[spinal cord]] can determine the [[extent]] of [[inflammation]] in [[symptoms]] and [[signs]] suggestive of [[myelopathy]]<ref name="pmid19038851">{{cite journal| author=Callen DJ, Shroff MM, Branson HM, Li DK, Lotze T, Stephens D | display-authors=etal| title=Role of MRI in the differentiation of ADEM from MS in children. | journal=Neurology | year= 2009 | volume= 72 | issue= 11 | pages= 968-73 | pmid=19038851 | doi=10.1212/01.wnl.0000338630.20412.45 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038851 }} </ref>. | |||
*Widespread, [[multifocal]] or extensive [[white matter]] [[lesions]], more than 50% of the total [[white matter]] volume<ref name="pmid11376179">{{cite journal| author=Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ| title=Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. | journal=Neurology | year= 2001 | volume= 56 | issue= 10 | pages= 1308-12 | pmid=11376179 | doi=10.1212/wnl.56.10.1308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11376179 }} </ref><ref name="pmid15289266">{{cite journal| author=Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C | display-authors=etal| title=MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. | journal=Brain | year= 2004 | volume= 127 | issue= Pt 9 | pages= 1942-7 | pmid=15289266 | doi=10.1093/brain/awh218 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15289266 }} </ref>. Bilateral abnormalities in the white to [[grey matter]] junction of the [[thalamus]] and [[basal ganglia]] have also been reported<ref name="pmid15295226">{{cite journal| author=Leake JA, Albani S, Kao AS, Senac MO, Billman GF, Nespeca MP | display-authors=etal| title=Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. | journal=Pediatr Infect Dis J | year= 2004 | volume= 23 | issue= 8 | pages= 756-64 | pmid=15295226 | doi=10.1097/01.inf.0000133048.75452.dd | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15295226 }} </ref>. | *Widespread, [[multifocal]] or extensive [[white matter]] [[lesions]], more than 50% of the total [[white matter]] volume<ref name="pmid11376179">{{cite journal| author=Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ| title=Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. | journal=Neurology | year= 2001 | volume= 56 | issue= 10 | pages= 1308-12 | pmid=11376179 | doi=10.1212/wnl.56.10.1308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11376179 }} </ref><ref name="pmid15289266">{{cite journal| author=Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C | display-authors=etal| title=MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. | journal=Brain | year= 2004 | volume= 127 | issue= Pt 9 | pages= 1942-7 | pmid=15289266 | doi=10.1093/brain/awh218 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15289266 }} </ref>. Bilateral abnormalities in the white to [[grey matter]] junction of the [[thalamus]] and [[basal ganglia]] have also been reported<ref name="pmid15295226">{{cite journal| author=Leake JA, Albani S, Kao AS, Senac MO, Billman GF, Nespeca MP | display-authors=etal| title=Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. | journal=Pediatr Infect Dis J | year= 2004 | volume= 23 | issue= 8 | pages= 756-64 | pmid=15295226 | doi=10.1097/01.inf.0000133048.75452.dd | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15295226 }} </ref>. | ||
*Despite the absence of specific criteria, especially for children<ref name="pmid15289266">{{cite journal| author=Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C | display-authors=etal| title=MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. | journal=Brain | year= 2004 | volume= 127 | issue= Pt 9 | pages= 1942-7 | pmid=15289266 | doi=10.1093/brain/awh218 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15289266 }} </ref>, follow up [[MRI]] scans at intervals no lesser than six months help establish or confirm the [[diagnosis]] of [[ADEM]]. The [[lesions]] should resolve or remain unchanged<ref name="pmid2328406">{{cite journal| author=Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D | display-authors=etal| title=Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. | journal=Brain | year= 1990 | volume= 113 ( Pt 2) | issue= | pages= 291-302 | pmid=2328406 | doi=10.1093/brain/113.2.291 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2328406 }} </ref>. | *Despite the absence of specific criteria, especially for children<ref name="pmid15289266">{{cite journal| author=Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C | display-authors=etal| title=MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. | journal=Brain | year= 2004 | volume= 127 | issue= Pt 9 | pages= 1942-7 | pmid=15289266 | doi=10.1093/brain/awh218 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15289266 }} </ref>, follow up [[MRI]] scans at intervals no lesser than six months help establish or confirm the [[diagnosis]] of [[ADEM]]. The [[lesions]] should resolve or remain unchanged<ref name="pmid2328406">{{cite journal| author=Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D | display-authors=etal| title=Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. | journal=Brain | year= 1990 | volume= 113 ( Pt 2) | issue= | pages= 291-302 | pmid=2328406 | doi=10.1093/brain/113.2.291 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2328406 }} </ref>. | ||
Revision as of 10:13, 18 November 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
MRI
MRI is the best method for further evaluation after an initial suspicion of ADEM. MRI brain with gadolinium enhancement is indicated in stable patients whereas, MRI of the dorsal and cervical spinal cord can determine the extent of inflammation in symptoms and signs suggestive of myelopathy[1].
- Widespread, multifocal or extensive white matter lesions, more than 50% of the total white matter volume[2][3]. Bilateral abnormalities in the white to grey matter junction of the thalamus and basal ganglia have also been reported[4].
- Despite the absence of specific criteria, especially for children[3], follow up MRI scans at intervals no lesser than six months help establish or confirm the diagnosis of ADEM. The lesions should resolve or remain unchanged[5].
References
- ↑ Callen DJ, Shroff MM, Branson HM, Li DK, Lotze T, Stephens D; et al. (2009). "Role of MRI in the differentiation of ADEM from MS in children". Neurology. 72 (11): 968–73. doi:10.1212/01.wnl.0000338630.20412.45. PMID 19038851.
- ↑ Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ (2001). "Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children". Neurology. 56 (10): 1308–12. doi:10.1212/wnl.56.10.1308. PMID 11376179.
- ↑ 3.0 3.1 Mikaeloff Y, Adamsbaum C, Husson B, Vallée L, Ponsot G, Confavreux C; et al. (2004). "MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood". Brain. 127 (Pt 9): 1942–7. doi:10.1093/brain/awh218. PMID 15289266.
- ↑ Leake JA, Albani S, Kao AS, Senac MO, Billman GF, Nespeca MP; et al. (2004). "Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features". Pediatr Infect Dis J. 23 (8): 756–64. doi:10.1097/01.inf.0000133048.75452.dd. PMID 15295226.
- ↑ Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D; et al. (1990). "Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis". Brain. 113 ( Pt 2): 291–302. doi:10.1093/brain/113.2.291. PMID 2328406.