Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt–Jakob disease

Shiga, Yusei; Miyazawa, Koichi; Satō, Shigeru; Fukushima, R; Shibuya, Satoshi; Satō, Yutaka; Konno, Hidehiko; Doh‐ura, Katsumi; Mugikura, Shunji; Tamura, H.; Higano, Shuichi; Takahashi, Satoshi; Itoyama, Yasuto

doi:10.1212/01.wnl.0000134555.59460.5d

Cited by 331 publications

(314 citation statements)

References 27 publications

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“…Unfortunately, this finding has a limited sensitivity of approximately 40-67%, only occur relatively late in the disease course and is mainly positive in the MM1 and MV1 molecular subtypes (8,(29)(30)(31)(32). Older age and shorter disease duration are correlated with increased likelihood of a positive test (33).…”

Section: Sporadic Creutzfeldt-jakob Diseasementioning

confidence: 99%

“…MRI is far more sensitive, especially with the addition of FLAIR and diffusionweighted imaging (DWI). DWI is the most useful sequence with reported sensitivity ranging from 86 to 94% (8)(9)(10)(11). DWI also benefit from greater inter-observer agreement compared with FLAIR or T2 (8).…”

Section: Neuroimagingmentioning

confidence: 99%

“…Another important advantage of this rapid sequence is its lesser sensitivity to motion artifacts, an important consideration in the setting of myoclonal jerks or uncooperative patients (8). In addition, higher b values were recently reported to further increase the sensitivity of DWI for the detection of subtle cases and, this may become an interesting adjunct in borderline situations (12).…”

Section: Neuroimagingmentioning

confidence: 99%

“…However, these reports have the potential of being flawed by the time delay between the imaging and autopsy, especially given the fact that the histological changes are known to evolve spatially over time. Indeed, DWI findings may become less conspicuous in the terminal stage of the disease and may even normalize (8,(16)(17)(18). This evolution may be related to increased gliosis, producing increased water diffusivity, thus balancing the restricted diffusion seen earlier in the disease (11,19).…”

Section: Neuroimagingmentioning

confidence: 99%

“…Older age and shorter disease duration are correlated with increased likelihood of a positive test (33). DWI may be positive in the absence of PSWCs (7,8,29). In addition to EEG, multiple CSF markers have been identified; the most frequently cited is the 14-3-3 protein, a marker of neuronal damage.…”

Section: Sporadic Creutzfeldt-jakob Diseasementioning

confidence: 99%

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Imaging of prion diseases

Létourneau-Guillon

Wada²,

Kucharczyk

2012

Magnetic Resonance Imaging

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Prion diseases are caused by self‐replicating proteins that induce lethal neurodegenerative disorders. In the last decade, the understanding of the different clinical, pathological, and neuroimaging phenotypes of this group of disorders has evolved paralleling the advances in prion molecular biology. From an imaging standpoint, the implementation of diffusion‐weighted imaging in routine practice has markedly facilitated the detection of prion diseases, especially Creutzfeldt‐Jakob. Less frequent prion‐related disorders, including genetic diseases, may also benefit from progresses in the field of quantitative diffusion‐weighted imaging, MR spectroscopy or molecular imaging. Herein, we present a review of the neuroimaging features of the prion disorders known to affect humans emphasizing the important contribution of MRI in the diagnosis of this group of disorders. J. Magn. Reson. Imaging 2012;35:998‐1012. © 2012 Wiley Periodicals, Inc.

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Section: Sporadic Creutzfeldt-jakob Diseasementioning

confidence: 99%

Section: Neuroimagingmentioning

confidence: 99%

Section: Neuroimagingmentioning

confidence: 99%

Section: Neuroimagingmentioning

confidence: 99%

Section: Sporadic Creutzfeldt-jakob Diseasementioning

confidence: 99%

See 3 more Smart Citations

Imaging of prion diseases

Létourneau-Guillon

Wada²,

Kucharczyk

2012

Magnetic Resonance Imaging

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Differential Diagnosis of Jakob-Creutzfeldt Disease

Paterson¹,

Torres-Chae²,

Kuo³

et al. 2012

Arch Neurol

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To identify the misdiagnoses of patients with sporadic Jakob-Creutzfeldt disease (sCJD) during the course of their disease and determine which medical specialties saw patients with sCJD prior to the correct diagnosis being made and at what point in the disease course a correct diagnosis was made.Design: Retrospective medical record review.Setting: A specialty referral center of a tertiary academic medical center.Participants: One hundred sixty-three serial patients over a 5.5-year period who ultimately had pathologically proven sCJD. The study used the subset of 97 patients for whom we had adequate medical records.Main Outcome Measures: Other diagnoses considered in the differential diagnosis and types of medical specialties assessing patients with sCJD.Results: Ninety-seven subjects' records were used in the final analysis. The most common disease categories of misdiagnosis were neurodegenerative, autoimmune/ paraneoplastic, infectious, and toxic/metabolic disor-ders. The most common individual misdiagnoses were viral encephalitis, paraneoplastic disorder, depression, vertigo, Alzheimer disease, stroke, unspecified dementia, central nervous system vasculitis, peripheral neuropathy, and Hashimoto encephalopathy. The physicians who most commonly made these misdiagnoses were primary care physicians and neurologists; in the 18% of patients who were diagnosed correctly at their first assessment, the diagnosis was almost always by a neurologist. The mean time from onset to diagnosis was 7.9 months, an average of two-thirds of the way through their disease course.Conclusions: Diagnosis of sCJD is quite delayed. When evaluating patients with rapidly progressive dementia with suspected neurodegenerative, autoimmune, infectious, or toxic/metabolic etiology, sCJD should also be included in the differential diagnosis, and appropriate diagnostic tests, such as diffusion brain magnetic resonance imaging, should be considered. Primary care physicians and neurologists need improved training in sCJD diagnosis.

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Human Growth Hormone–Related Iatrogenic Creutzfeldt-Jakob Disease With Abnormal Imaging

Lewis

Yu²,

DeArmond³

et al. 2006

Arch Neurol

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Background: Although more than 160 cases of iatrogenic Creutzfeldt-Jakob disease (iCJD) from human growth hormone (hGH) treatment have been documented, to our knowledge abnormal cerebellar findings on magnetic resonance imaging (MRI) have not been reported. Objective: To report a case of hGH-related iCJD with abnormal cerebellar MRI findings on fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted MRI (DWI). Design: Case report. Setting: Outpatient neurology clinic at a university medical center. Patient: A 33-year old man who had subacute gait ataxia and blurred vision.

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Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt–Jakob disease

Abstract: DWI can detect characteristic lesions in the majority of patients with CJD regardless of the presence of PSWCs. DWI was the most sensitive test for the early clinical diagnosis of CJD; consideration should be given to its inclusion in the clinical diagnostic criteria of CJD.

Cited by 331 publications

References 27 publications

Imaging of prion diseases

Imaging of prion diseases

Differential Diagnosis of Jakob-Creutzfeldt Disease

Human Growth Hormone–Related Iatrogenic Creutzfeldt-Jakob Disease With Abnormal Imaging

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