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MR Imaging of Central Nervous System Whipple Disease: A 15-Year Review

MR Imaging of Central Nervous System Whipple Disease: A 15-Year Review This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2089v1 31/8/1493 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Black, D. F. Articles by Morris, J. M. PubMed PubMed Citation Articles by Black, D. F. Articles by Morris, J. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:1493-1497, September 2010 © 2010 American Society of Neuroradiology BRAIN MR Imaging of Central Nervous System Whipple Disease: A 15-Year Review D.F. Black a , A.J. Aksamit b and J.M. Morris a a Departments of Radiology (D.F.B., J.M.M.) b Neurology (A.J.A.), Mayo Clinic, Rochester, Minnesota. Please address correspondence to David F. Black, MD, Mayo Clinic Radiology–E2, 200 First St SW, Rochester, MN 55905; e-mail: black.david@mayo.edu SUMMARY: CNS WD is fatal if antibiotics are not begun early, but knowledge regarding the variety of presentations on MR imaging is limited. In order to more effectively recognize this entity on MR imaging, the Mayo Clinic medical records were reviewed for subjects diagnosed with CNS WD from 1992-2006 who had also undergone MR imaging of the neuraxis. Seven subjects were identified and their imaging findings were reviewed by the authors. Four of 7 had head MR imaging findings indicative of WD. Two subjects demonstrated high T2 signal within the corticospinal tracts. CNS WD may demonstrate high T2 signal with minimal enhancement and no restricted diffusion, primarily in the midline of the midbrain, hypothalamus, and mesial temporal lobes and occasionally the corticospinal tracts. MR imaging may also be normal. Radiologists should be aware of these presentations and be prepared to mention CNS WD as a diagnostic possibility since early antibiotic therapy may significantly impact morbidity and mortality. Abbreviations: asxs, asymptomatic • CNS, central nervous system • FLAIR, fluid-attenuated inversion recovery • GI, gastrointestinal • NP, not performed • PAS, periodic-acid-Schiff • PCR, polymerase chain reaction • Rx, therapy • WD, Whipple disease Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

MR Imaging of Central Nervous System Whipple Disease: A 15-Year Review

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2089
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2089v1 31/8/1493 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Black, D. F. Articles by Morris, J. M. PubMed PubMed Citation Articles by Black, D. F. Articles by Morris, J. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:1493-1497, September 2010 © 2010 American Society of Neuroradiology BRAIN MR Imaging of Central Nervous System Whipple Disease: A 15-Year Review D.F. Black a , A.J. Aksamit b and J.M. Morris a a Departments of Radiology (D.F.B., J.M.M.) b Neurology (A.J.A.), Mayo Clinic, Rochester, Minnesota. Please address correspondence to David F. Black, MD, Mayo Clinic Radiology–E2, 200 First St SW, Rochester, MN 55905; e-mail: black.david@mayo.edu SUMMARY: CNS WD is fatal if antibiotics are not begun early, but knowledge regarding the variety of presentations on MR imaging is limited. In order to more effectively recognize this entity on MR imaging, the Mayo Clinic medical records were reviewed for subjects diagnosed with CNS WD from 1992-2006 who had also undergone MR imaging of the neuraxis. Seven subjects were identified and their imaging findings were reviewed by the authors. Four of 7 had head MR imaging findings indicative of WD. Two subjects demonstrated high T2 signal within the corticospinal tracts. CNS WD may demonstrate high T2 signal with minimal enhancement and no restricted diffusion, primarily in the midline of the midbrain, hypothalamus, and mesial temporal lobes and occasionally the corticospinal tracts. MR imaging may also be normal. Radiologists should be aware of these presentations and be prepared to mention CNS WD as a diagnostic possibility since early antibiotic therapy may significantly impact morbidity and mortality. Abbreviations: asxs, asymptomatic • CNS, central nervous system • FLAIR, fluid-attenuated inversion recovery • GI, gastrointestinal • NP, not performed • PAS, periodic-acid-Schiff • PCR, polymerase chain reaction • Rx, therapy • WD, Whipple disease Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Sep 1, 2010

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