Download presentation
Presentation is loading. Please wait.
Published byJohn Powell Modified over 9 years ago
1
* Creutzfeldt–Jakob disease Posterior Reversible Encephalopathy Syndrome Progressive Multifocal Leukoencephalopathy
2
* Typical / Atypical * Diffusion
4
JH Hise Radiology 1996:199 793-8
5
Young J. AJNR 2005 vol. 26 (6) pp. 1551 mental decline /dementia ataxia, sometimes visual disturbances
6
* sCJD – sporadic - 85% * fCJD – famial – 15% * Other less than 1% * vCJD – variant * Iatrogenic CJD Young G AJNR 2003 vol. 24 (8) pp. 1560
7
* Definite – Path proven * Probable * EEG * CSF 14-3-3 protein Young G AJNR 2003 vol. 24 (8) pp. 1560
8
Young J. AJNR 2005 vol. 26 (6) pp. 1551 Kids normal BG bright Adults less from iron
9
40 yo Young J. AJNR 2005 vol. 26 (6) pp. 1551 Isolated Basal ganglia involvement 5%
10
58% BG and cortex 35% Cortex 7% Neg B Messnier AJNR 2008 vol. 29 (8) pp. 1519
11
B =1000B=3000 H Hyare. AJNR 2010 vol. 31 (3) pp. 521
12
Molloy S AJNR 2000 vol. 175 (2) pp. 55 Psychiatric and painful sensory symptoms
13
D Collie AJNR 2003 vol. 24 (8) pp. 1560
15
Fulbright R. AJNR 2008 vol. 29 (9) pp. 1638
16
Ryutarou U RadioGraphics 2006; 26:S191–S204 27 weeks
17
BC Tzeng. AJNR 1997 vol. 18 (3) pp. 583
18
Amogh N. Hegde, MD, FRCR RadioGraphics 2011; 31:5–30
21
Bartynski W. AJNR 2008 vol. 29 (6) pp. 1036
22
1 month Follow up Bartynski W. AJNR 2006 vol. 27 (10) pp. 2179
23
Covarrubias D. AJNR 2002 vol. 23 (6) pp. 1038
25
Bartynski W. AJNR 2007 vol. 28 (7) pp. 1320
28
Mckinny A. AJR 2007 vol. 189 (4) pp. 904
31
W Bartynski AJNR 2007 vol. 28 (7) pp. 1320
32
Mckinny A. AJR 2007 vol. 189 (4) pp. 904
34
H Hefzy AJNR 2009 vol. 30 (7) pp. 1371
35
Mckinny A. AJR 2007 vol. 189 (4) pp. 904
36
Bartynski W. AJNR 2008 vol. 29 (6) pp. 1036
37
W Bartynsk AJNR 2006 vol. 27 (10) pp. 2179 Follow up
38
W Bartynsk AJNR 2006 vol. 27 (10) pp. 2179 11 day Follow up
39
W Bartynsk AJNR 2006 vol. 27 (10) pp. 2179 SPECT HMPAO Tc-99m
41
Smith AB Radiographics 28 (7) 2033-58 2008
43
Bag A. AJNR 2010 vol. 31 (9) pp. 1564
44
Case 1 bx proven Case 2 PCR for JC in CSF initial1 month later Normal 3 years prior PML
45
* 5% of AIDS on autopsy * 90% die in 1 year without tx * PCR test for JC virus in CSF * JC virus infect oligodendrocytes,
46
* PML without tx 4 months life expectancy * PML with tx increased the 1-year survival rate by 10%–50%. Bergui M,Neuroradiology 2004;46:22–25 Clifford DB Neurology 1999;52:623–25
47
Bag A. AJNR 2010 vol. 31 (9) pp. 1564
48
B=1000 B=3000 Usiskin SI AJNR 28 Feb 2007
49
DWI B=3000 DWI FA Initial 4 week after Tx
51
Smith AB Radiographics 28 (7) 2033-58 2008 IRIS : immune reconstitution inflammatory syndrome
52
Smith AB Radiographics 28 (7) 2033-58 2008
53
* JCV granular cell neuronopathy– isolated cerebellar atrophy * JC meningitis – negative imaging * JC encephalitis – cortical involvement Is PML still an adequate name?
54
Wuthrich C. Ann Neurol 2009;65:742– 48 3 months later Cortical pyramidal cell infected
56
Bag A. AJNR 2010 vol. 31 (9) pp. 1564
57
Initial – infarct? 1 month later, no Tx On HAART 19 months
58
Bag A. AJNR 2010 vol. 31 (9) pp. 1564
61
* 1) Progressive clinical disease. * 2) Typical MR imaging findings. * 3) Demonstration of JCV DNA in the CSF.
62
* 1) Diffuse subcortical rather than periventricular white matter involvement; frequent involvement of posterior fossa. * 2) Irregular ill-defined infiltrating edge confined to the white matter. * 3) Persistent progression of the lesion confined within the white matter tract. * 4) No mass effect even in large lesions. * 5) Diffuse increased T2 signal intensity; recently involved areas more T2 hyperintense than the old areas. * 6) Initially iso- to hypointense with an incremental drop of * T1 signal intensity with time; signal intensity never returning to normal. * 7) Typically no enhancement, even in large lesions.
63
Review
65
Young G AJNR Am J Neuroradiol 26:1551–1562, June/July 2005
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.