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Delayed appearance of transient hyperintensity foci on T1-weighted magnetic resonance imaging in acute disseminated encephalomyelitis

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Abstract

Purpose

To evaluate the frequency, characteristics, and clinical significance of transient hyperintensity foci on T1-weighted images (T1WI) in acute disseminated encephalomyelitis (ADEM).

Materials and methods

Patients diagnosed with ADEM underwent MR studies at the time of disease onset and every 3 months or more often thereafter. The frequency and appearance timing of abnormal signals including T1WI and their morphological characteristics were evaluated. Relations between patient symptoms and abnormal signals on MRI were also evaluated.

Results

Five ADEM patients were included in this study. Linear (n = 2) or nodular (n = 1) T1-hyperintensity foci appeared in 3 patients (60%, 3/5). Locations of T1-hyperintensity foci were both cortical/subcortical region and basal ganglia (n = 1), subcortical region alone (n = 1), and internal capsule (n = 1). Those T1-hyperintensity foci were located within the T2-weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) hyperintensity foci on initial MRI. Some T1-hyperintensity foci also showed hyperintensity on diffusion-weighted image (DWI) and contrast enhancement. T1-hyperintensity appeared at 14–43 days (median, 28 days), and disappeared in 2 patients at 91 days and 627 days after disease onset. There were no neurological sequelae remained in any patients.

Conclusion

T1-hyperintensity foci is not a rare finding (60%) and it can be observed after improvement in symptoms in ADEM.

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Authors and Affiliations

  1. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Prefecture, Japan

    Yusuke Kawanaka, Kumiko Ando, Reiichi Ishikura, Takayuki Katsuura, Yuki Wakata, Hiroshi Kodama, Haruyuki Takaki & Koichiro Yamakado

  2. Department of Radiology, Meiwa Hospital, Nishinomiya, Japan

    Yoshihiro Takada

  3. Department of Pediatrics, Meiwa Hospital, Nishinomiya, Japan

    Junichiro Ono

Authors
  1. Yusuke Kawanaka
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  2. Kumiko Ando
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  3. Reiichi Ishikura
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  4. Takayuki Katsuura
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  5. Yuki Wakata
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  6. Hiroshi Kodama
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  7. Haruyuki Takaki
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  8. Yoshihiro Takada
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  9. Junichiro Ono
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  10. Koichiro Yamakado
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Corresponding author

Correspondence to Yusuke Kawanaka.

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Conflict of interest

No author has any conflict of interest to declare.

Ethical standards

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical approval

This retrospective study was approved by our institutional review board.

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Cite this article

Kawanaka, Y., Ando, K., Ishikura, R. et al. Delayed appearance of transient hyperintensity foci on T1-weighted magnetic resonance imaging in acute disseminated encephalomyelitis. Jpn J Radiol 37, 277–282 (2019). https://doi.org/10.1007/s11604-018-00808-w

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  • DOI: https://doi.org/10.1007/s11604-018-00808-w

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