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Diffusion weighted MR imaging in non-infarct lesions of the brain

      Abstract

      Diffusion weighted imaging (DWI) is a relatively new method in which the images are formed by the contrast produced by the random microscopic motion of water molecules in different tissues. Although DWI has been tried for different organ systems, it has been found its primary use in the central nervous system. The most widely used clinical application is in the detection of hyperacute infarcts and the differentiation of acute or subacute infarction from chronic infarction. Recently DWI has been applied to various other cerebral diseases. In this pictorial paper the authors demonstrated different DWI patterns of non-infarct lesions of the brain which are hyperintense in the diffusion trace image, such as infectious, neoplastic and demyelinating diseases, encephalopathies – including hypoxic–ischemic, hypertensive, eclamptic, toxic, metabolic and mitochondrial encephalopathies – leukodystrophies, vasculitis and vasculopathies, hemorrhage and trauma.

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      References

        • Moseley M.E.
        • Cohen Y.
        • Mintorovitch J.
        Early detection of regional cerebral ischemia in cats: comparison of diffusion- and T2-weighted MRI and spectrosopy.
        Magn Reson Med. 1990; 14: 330-346
        • Moritani T.
        • Shrier D.A.
        • Numaguchi Y.
        • et al.
        Diffusion-weighted echo-planar MR imaging: clinical applications and pitfalls—a pictorial essay.
        Clin Imaging. 2000; 24: 181-192
        • van Pul C.
        • Buijs J.
        • Janssen M.J.
        • Roos G.F.
        • Vlaardingerbroek M.T.
        • Wijn P.F.
        Selecting the best index for following the temporal evolution of apparent diffusion coefficient and diffusion anisotropy after hypoxic–ischemic white matter injury in neonates.
        AJNR Am J Neuroradiol. 2005; 26: 469-481
        • Kealey S.M.
        • Kim Y.
        • Whiting W.L.
        • Madden D.J.
        • Provenzale J.M.
        Determination of multiple sclerosis plaque size with diffusion-tensor MR Imaging: comparison study with healthy volunteers.
        Radiology. 2005; 236: 615-620
        • Yamasaki F.
        • Kurisu K.
        • Satoh K.
        • et al.
        Apparent diffusion coefficient of human brain tumors at MR imaging.
        Radiology. 2005; 235: 985-991
        • Erdogan C.
        • Hakyemez B.
        • Yildirim N.
        • Parlak M.
        Brain abscess and cystic brain tumor: discrimination with dynamic susceptibility contrast perfusion-weighted MRI.
        J Comput Assist Tomogr. 2005; 29: 663-667
        • Ebisu T.
        • Tanaka C.
        • Umeda M.
        • et al.
        Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging.
        Magn Reson Imaging. 1996; 14: 1113-1116
        • Stadnik T.W.
        • Demaerel P.
        • Luypaert R.R.
        • et al.
        Imaging tutorial: diferential diagnosis of bright lesions on diffusion-weighted MR images.
        Radiographics. 2003; 23: e7
        • Heiner L.
        • Demaerel P.
        Diffusion-weighted MR imaging findings in a patient with herpes simplex encephalitis.
        Eur J Radiol. 2003; 45: 195-198
        • Struffert T.
        • Reith W.
        Herpes simplex virus encephalitis: neuroradiologic differential diagnosis.
        Radiologe. 2000; 40: 1011-1016
        • Tschampa H.J.
        • Zerr I.
        • Urbach H.
        Radiological assessment of Creutzfeldt–Jakob disease.
        Eur Radiol. 2007; 17: 1200-1211
        • Falcone S.
        • Quencer R.M.
        • Bowen B.
        • Bruce J.H.
        • Naidich T.P.
        Creutzfeldt–Jakob disease: focal symmetrical cortical involvement demonstrated by MR imaging.
        AJNR Am J Neuroradiol. 1992; 13: 403-406
        • Lim C.C.
        • Tan K.
        • Verma K.K.
        • Yin H.
        Combined diffusion-weighted and spectroscopic MR imaging in Creutzfeldt–Jakob disease.
        Magn Reson Imaging. 2004; 22: 625-629
        • Kitis O.
        • Altay H.
        • Calli C.
        • Yunten N.
        • Akalin T.
        • Yurtseven T.
        Minimum apparent diffusion coefficients in the evaluation of brain tumors.
        Eur J Radiol. 2005; 55: 393-400
        • Rumboldt Z.
        • Camacho D.L.A.
        • Lake D.
        • Welsh C.T.
        • Castillo M.
        Apparent diffusion coefficients for differentiation of cerebellar tumors in children.
        AJNR. 2006; 27: 1362-1369
        • Küker W.
        • Nagele T.
        • Thiel E.
        • Weller M.
        • Herrlinger U.
        Primary central nervous system lymphomas (PCNSL): MRI response criteria revised.
        Neurology. 2005; 65: 1129-1131
        • Song D.K.
        • Boulis N.M.
        • McKeever P.E.
        • Quint D.J.
        Angiotropic large cell lymphoma with imaging characteristics of CNS vasculitis.
        AJNR Am J Neuroradiol. 2002; 23: 239-242
        • Kim E.Y.
        • Kim S.S.
        Magnetic resonance findings of primary central nervous system T-cell lymphoma in immunocompetent patients.
        Acta Radiol. 2005; 46: 187-192
        • Desprechins B.
        • Stadnik T.
        • Koerts G.
        • Shabana W.
        • Breucq C.
        • Osteaux M.
        Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses.
        AJNR Am J Neuroradiol. 1999; 20: 1252-1257
        • Tsuruda J.S.
        • Chew W.M.
        • Moseley M.E.
        • Norman D.
        Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors.
        AJR Am J Roentgenol. 1990; 155: 1059-1065
        • Annet L.
        • Duprez T.
        • Grandin C.
        • Dooms G.
        • Collard A.
        • Cosnard G.
        Apparent diffusion coefficient measurements within intracranial epidermoid cysts in six patients.
        Neuroradiology. 2002; 44: 326-328
        • Hakyemez B.
        • Aksoy U.
        • Yildiz H.
        • Ergin N.
        Intracranial epidermoid cysts: diffusion-weighted FLAIR and conventional MR findings.
        Eur J Radiol. 2005; 54: 214-220
        • Liu P.
        • Saida Y.
        • Yoshioka H.
        • Itai Y.
        MR imaging of epidermoids at the cerebellopontine angle.
        Magn Reson Med Sci. 2003; 2: 109-115
        • Rutherford M.
        • Counsell S.
        • Allsop J.
        • et al.
        Diffusion-weighted magnetic resonance imaging in term perinatal brain injury: a comparison with site of lesion and time from birth.
        Pediatrics. 2004; 114: 1004-1014
        • Kinoshita T.
        • Moritani T.
        • Shrier D.A.
        • et al.
        Diffusion-weighted MR imaging of posterior reversible leukoencephalopathy syndrome: a pictorial essay.
        Clin Imaging. 2003; 27: 307-315
        • Nagata M.
        • Maeda M.
        • Tsukahara H.
        • Maier S.E.
        • Takeda K.
        Brain stem hypertensive encephalopathy evaluated by line scan diffusion-weighted imaging.
        AJNR Am J Neuroradiol. 2004; 25: 803-806
        • Aydin K.
        • Donmez F.
        • Tuzun U.
        • Minareci O.
        • Atamer T.
        Diffusion MR findings in cyclosporin-A induced encephalopathy.
        Neuroradiology. 2004; 46: 822-824
        • Fisher M.J.
        • Khademian Z.P.
        • Simon E.M.
        • Zimmerman R.A.
        • Bilaniuk L.T.
        Diffusion-weighted MR imaging of early methotrexate-related neurotoxicity in children.
        AJNR Am J Neuroradiol. 2005; 26: 1686-1689
        • Küker W.
        • Bader P.
        • Herrlinger U.
        • Heckl S.
        • Nagele T.
        Transient encephalopathy after intrathekal methotrexate chemotherapy: diffusion-weighted MRI.
        J Neurooncol. 2005; 73: 47-49
        • Wada A.
        • Yoshida R.
        • Oda K.
        • Fukuba E.
        • Uchida N.
        • Kitagaki H.
        Acute encephalopathy associated with intravenous immunoglobulin therapy.
        AJNR Am J Neuroradiol. 2005; 26: 2311-2315
        • Lee P.H.
        • Shin D.H.
        • Kim J.W.
        • Song Y.S.
        • Kim H.S.
        Parkinsonism with basal ganglia lesions in a patient with uremia: evidence of vasogenic edema.
        Parkinsonism Relat Disord. 2006; 12: 93-96
        • White M.L.
        • Zhang Y.
        • Andrew L.G.
        • Hadley W.L.
        MR imaging with diffusion-weighted imaging in acute and chronic Wernicke encephalopathy.
        AJNR Am J Neuroradiol. 2005; 26: 2306-2310
        • Patay Z.
        Diffusion-weighted MR imaging in leukodystrophies.
        Eur Radiol. 2005; : 2284-2303
        • Toft P.B.
        • Geiss-Holtorff R.
        • Rolland M.O.
        • Pryds O.
        • Muller-Forell W.
        • Christensen E.
        Magnetic resonance imaging in juvenile Cnavan disease.
        Eur J Pediatr. 1993; 152: 750-753
        • Yalcinkaya C.
        • Benbir G.
        • Salomons G.S.
        • et al.
        Atypical MRI findings in Canavan disease: a patient with a mild course.
        Neuropediatrics. 2005; 36: 336-339
        • Kono K.
        • Okano Y.
        • Nakayama K.
        • et al.
        Diffusion-weighted MR imaging in patients with phenylketonuria: relationship between serum phenylalanine levels and ADC values in cerebral white matter.
        Radiology. 2005; 236: 630-636
        • Sener R.N.
        Tyrosinemia: computed tomography, magnetic resonance imaging, diffusion magnetic resonance imaging, and proton spectroscopy findings in the brain.
        J Comput Assist Tomogr. 2005; 29: 323-325
        • Sacher M.
        • Fatterpekar G.M.
        • Edelstein S.
        • Sansaricq C.
        • Naidich T.P.
        MRI findings in an atypical case of Kearns–Sayre syndrome: a case report.
        Neuroradiology. 2005; 47: 241-244
        • Wang X.Y.
        • Noguchi K.
        • Takashima S.
        • Hayashi N.
        • Ogawa S.
        • Seto H.
        Serial diffusion-weighted imaging in a patient with MELAS and presumed cytotoxic oedema.
        Neuroradiology. 2003; 45: 640-643
        • Tievsky A.L.
        • Ptak T.
        • Farkas J.
        Investigation of apparent diffusion coefficient and diffusion tensor anisotrophy in acute and chronic multiple sclerosis lesions.
        AJNR Am J Neuroradiol. 1999; 20: 1491-1499
        • Chua G.C.
        • Sitoh Y.Y.
        • Lim C.C.
        • Chua H.C.
        • Ng P.Y.
        MRI findings in osmotic myelinolysis.
        Clin Radiol. 2002; 57: 800-806
        • Barkovich A.J.
        Toxic and metabolic brain disorders.
        in: Barkovich A.J. Pediatric neuroimaging. 4th ed. Lipincott Williams and Wilkins, Philadelphia2005: 116-118
        • Briellmann R.S.
        • Wellard R.M.
        • Jackson G.D.
        Seizure-associated abnormalities in epilepsy: evidence from MR imaging..
        Epilepsia. 2005; 46: 760-766
        • Sener R.N.
        Neuro-Behcet's disease: diffusion MR imaging and proton MR spectroscopy.
        AJNR Am J Neuroradiol. 2003; 24: 1612-1614
        • Moritani T.
        • Hiwatashi A.
        • Shrier D.A.
        • Wang H.Z.
        • Numaguchi Y.
        • Westesson P.L.
        CNS vasculitis and vasculopathy: efficacy and usefulness of diffusion-weighted echoplanar MR imaging.
        Clin Imaging. 2004; 28: 261-270
        • Atlas S.W.
        • DuBois P.
        • Singer M.B.
        • Lu D.
        Diffusion measurements in intracranial hematomas: implications for MR imaging of acute stroke.
        AJNR Am J Neuroradiol. 2000; 21: 1179-1180
        • Silvera S.
        • Oppenheim C.
        • Touze E.
        • et al.
        Spontaneous intracerebral hematoma on diffusion-weighted images: influence of T2-shine-through and T2-blackout effects.
        AJNR Am J Neuroradiol. 2005; 26: 236-241
        • Moon W.J.
        • Na D.G.
        • Kim S.S.
        • Ryoo J.W.
        • Chung E.C.
        Diffusion abnormality of deep gray matter in external capsular hemorrhage.
        AJNR Am J Neuroradiol. 2005; 26: 229-235
        • Kinoshita T.
        • Moritani T.
        • Hiwatashi A.
        • et al.
        Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging.
        Eur J Radiol. 2005; 56: 5-11
        • Huisman T.A.
        • Sorensen A.G.
        • Hergan K.
        • Gonzalez R.G.
        • Schaefer P.W.
        Diffusion-weighted imaging for the evaluation of diffuse axonal injury in closed head injury.
        J Comput Assist Tomogr. 2003; 27: 5-11
        • Schaefer P.W.
        • Huisman T.A.
        • Sorensen A.G.
        • Gonzalez R.G.
        • Schwamm L.H.
        Diffusion-weighted MR imaging in closed head injury: high correlation with initial glasgow coma scale score and score on modified Rankin scale at discharge.
        Radiology. 2004; 233: 58-66