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PT  - JOURNAL ARTICLE
AU  - Kallenberg, K.
AU  - Schulz-Schaeffer, W.J.
AU  - Jastrow, U.
AU  - Poser, S.
AU  - Meissner, B.
AU  - Tschampa, H.J.
AU  - Zerr, I.
AU  - Knauth, M.
TI  - Creutzfeldt-Jakob Disease: Comparative Analysis of MR Imaging Sequences
DP  - 2006 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1459--1462
VI  - 27
IP  - 7
4099  - http://www.ajnr.org/content/27/7/1459.short
4100  - http://www.ajnr.org/content/27/7/1459.full
SO  - Am. J. Neuroradiol.2006 Aug 01; 27
AB  - BACKGROUND AND PURPOSE: MR imaging has played an increasingly important role in the diagnosis of Creutzfeldt-Jakob disease (CJD) since basal ganglia abnormalities on T2-weighted images have been described; thus, the aim of our study was to compare the value of different MR images in the diagnosis of CJD.METHODS: One hundred fifty-seven patients with CJD underwent MR imaging examinations. Ninety-two patients were neuropathologically confirmed, and 65 were clinically classified as having CJD through the CJD Surveillance Unit (probability of 95%). There was no standardized MR imaging protocol; thus, the examinations included 143 T2-weighted, 43 proton attenuation (PD)-weighted, 84 fluid-attenuated inversion recovery (FLAIR), and 44 diffusion-weighted images (DWI). The MR images were reviewed for pathologic changes of the basal ganglia, thalamus, and cerebral cortex.RESULTS: Cortical abnormalities were present in 70 patients (45%) and were visible in 80% (35/44) of all available DWI examinations. The basal ganglia were affected in 94 patients (60%), in particular in the caudate nucleus; the most sensitive sequences were DWI (64%) and PD-weighted (63%). A thalamic involvement was more frequently diagnosed on PD-weighted images (19%) and DWI (14%) than on FLAIR or T2-weighted images.CONCLUSION: PD-weighted images and DWI showed better results in the diagnosis of signal intensity changes in the basal ganglia compared with T2-weighted or FLAIR images; however, in the diagnosis of cortical changes, DWI was clearly superior. Our data suggest that DWI is the most sensitive MR imaging technique in the diagnosis of CJD.