Lyme disease MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
MRI is not helpful in diagnosis of Lyme disease. However, an MRI may be helpful in diagnosing neurologic manifestations of early and late disseminated Lyme disease. MRI scan in patients with neurological Lyme disease may demonstrate increased intensity in white matter at multiple foci on T2-weighted images, suggesting demyelination or inflammatory changes. After antibiotic therapy, spontaneous resolution of MRI white matter hyper-intensities has been observed in Lyme disease.
MRI
- Abnormal magnetic resonance imaging (MRI) findings are often seen in both early and late disseminated Lyme disease.[1]
- MRI scans of patients with neurologic manifestations of Lyme disease may demonstrate increased intensity in white matter at multiple foci on T2-weighted images, suggesting demyelination or inflammatory changes.[2]
- These changes are similar to those seen in demyelinating or inflammatory disorders such as multiple sclerosis or systemic lupus erythematosus (SLE).[3]
- MRI scan of a few patients with neurologic manifestations of Lyme disease may show cerebral atrophy and brainstem neoplasm.[4]
- MRI scan of a few patients with facial palsy may show enhancement of facial nerve.[5]
- Diffuse white matter pathology can disrupt these ubiquitous gray matter connections and could account for deficits in attention, memory, visuospatial ability, complex cognition, and emotional status.
- White matter disease may have a greater potential for recovery than gray matter disease, perhaps because neuronal loss is less common in white matter disease.
- After antibiotic therapy, spontaneous resolution of MRI white matter hyper-intensities has been observed in Lyme disease.[6]
References
- ↑ Aalto A, Sjöwall J, Davidsson L, Forsberg P, Smedby O (2007). "Brain magnetic resonance imaging does not contribute to the diagnosis of chronic neuroborreliosis". Acta Radiol. 48 (7): 755–62. doi:10.1080/02841850701367903. PMID 17729007.
- ↑ Belman AL, Coyle PK, Roque C, Cantos E (1992). "MRI findings in children infected by Borrelia burgdorferi". Pediatr Neurol. 8 (6): 428–31. PMID 1476570.
- ↑ Fallon BA, Kochevar JM, Gaito A, Nields JA (1998). "The underdiagnosis of neuropsychiatric Lyme disease in children and adults". Psychiatr Clin North Am. 21 (3): 693–703, viii. PMID 9774805.
- ↑ Kalina P, Decker A, Kornel E, Halperin JJ (2005). "Lyme disease of the brainstem". Neuroradiology. 47 (12): 903–7. doi:10.1007/s00234-005-1440-2. PMID 16158278.
- ↑ Vanzieleghem B, Lemmerling M, Carton D, Achten E, Vanlangenhove P, Matthys E; et al. (1998). "Lyme disease in a child presenting with bilateral facial nerve palsy: MRI findings and review of the literature". Neuroradiology. 40 (11): 739–42. PMID 9860125.
- ↑ Fallon BA, Keilp J, Prohovnik I, Heertum RV, Mann JJ (2003). "Regional cerebral blood flow and cognitive deficits in chronic lyme disease". The Journal of neuropsychiatry and clinical neurosciences. 15 (3): 326–32. PMID 12928508.