Bahn M M, Parchi P
Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo 63110, USA.
Arch Neurol. 1999 May;56(5):577-83. doi: 10.1001/archneur.56.5.577.
Traditional imaging methods, including computed tomography, routine magnetic resonance imaging (MRI), and magnetic resonance spectroscopy, have not been particularly useful in the diagnosis of Creutzfeldt-Jakob disease (CJD). Although abnormalities can be seen using these methods, the findings are evident only late in the disease or lack specificity or sensitivity.
To describe abnormalities on diffusion-weighted MRIs in 4 patients with proven CJD.
Diffusion-weighted MRIs were obtained on 4 patients with CJD as part of a routine MRI brain examination.
In all 4 patients, diffusion-weighted MRIs of the brain demonstrated bilateral hyperintensity in the basal ganglia. In 1 patient, the most conspicuous abnormality seen in diffusion-weighted images was in the thalamus. Two patients also demonstrated hyperintensity in the cerebral cortex on diffusion-weighted images. Only 2 of 4 patients demonstrated clear abnormalities on routine (non-diffusion-weighted) MRIs. Diffusion abnormalities were visible in 1 patient within 1 month of symptom onset. The findings were most conspicuous and extensive in the patient with the longest duration of symptoms (7 months).
Diffusion-weighted MRI might provide a noninvasive method of identifying patients with CJD. However, further investigations must be performed to determine the specificity of these findings for CJD.
传统成像方法，包括计算机断层扫描、常规磁共振成像（MRI）和磁共振波谱，在克雅氏病（CJD）的诊断中并非特别有用。尽管使用这些方法可以看到异常，但这些发现仅在疾病晚期才明显，或者缺乏特异性或敏感性。
描述4例经证实患有CJD患者的扩散加权MRI异常情况。
对4例CJD患者进行扩散加权MRI检查，作为常规脑部MRI检查的一部分。
所有4例患者的脑部扩散加权MRI均显示基底节区双侧高信号。1例患者在扩散加权图像中最明显的异常出现在丘脑。2例患者在扩散加权图像上还显示大脑皮质高信号。4例患者中只有2例在常规（非扩散加权）MRI上显示明显异常。1例患者在症状出现后1个月内可见扩散异常。在症状持续时间最长（7个月）的患者中，这些发现最为明显和广泛。
扩散加权MRI可能提供一种识别CJD患者的非侵入性方法。然而，必须进行进一步研究以确定这些发现对CJD的特异性。
