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1H-MRS for the diagnosis of acute disseminated encephalomyelitis: insight into the acute-disease stage

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Abstract

Background

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder of the central nervous system (CNS). Differentiating ADEM from other inflammatory disorders, such as multiple sclerosis, is not always conclusive using conventional MRI.

Objective

To evaluate longitudinal magnetic resonance spectroscopy (MRS) changes that distinguish ADEM from other inflammatory disorders.

Materials and methods

MRI/MRS scans were performed in seven patients with ADEM during the acute and chronic phases of the disease.

Results

Partial recovery was detected between the acute and chronic phases in choline/creatine ratio. Major elevation of lipids and reduction in myo-inositol/creatine ratio was detected in all patients during the acute phase, followed by a reduction in lipids peak and elevation above normal in myo-inositol/creatine ratio during the chronic phase.

Conclusion

Consistent and unique MRS changes in metabolite ratios between the acute and chronic presentations of the disease were found. To the best of our knowledge, these patterns have not been described in other inflammatory disorders and might assist in the early diagnosis of ADEM.

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Authors and Affiliations

  1. Department of Radiology, Tel Aviv Sourasky Medical Center, Tel-Aviv, 64239, Israel

    Liat Ben Sira & Elka Miller

  2. Functional Brain Imaging Center, Tel Aviv Sourasky Medical Center, Weitzman Street 6, Tel-Aviv, Israel

    Moran Artzi & Dafna Ben Bashat

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Moran Artzi, Aviva Fattal-Valevski & Shlomi Constantini

  4. Paediatric Neurology Unit, The Paediatric Neurosurgery Department, Tel Aviv Medical Center, Tel Aviv, Israel

    Aviva Fattal-Valevski & Shlomi Constantini

Authors
  1. Liat Ben Sira
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  2. Elka Miller
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  3. Moran Artzi
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  4. Aviva Fattal-Valevski
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  5. Shlomi Constantini
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  6. Dafna Ben Bashat
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Correspondence to Dafna Ben Bashat.

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Ben Sira, L., Miller, E., Artzi, M. et al. 1H-MRS for the diagnosis of acute disseminated encephalomyelitis: insight into the acute-disease stage. Pediatr Radiol 40, 106–113 (2010). https://doi.org/10.1007/s00247-009-1372-9

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  • DOI: https://doi.org/10.1007/s00247-009-1372-9

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