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

Liat Ben Sira, Elka Miller, Moran Artzi, Aviva Fattal-Valevski, Shlomi Constantini, Dafna Ben Bashat

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)106-113
Number of pages8
JournalPediatric Radiology
Volume40
Issue number1
DOIs
StatePublished - Jan 2010

Keywords

  • ADEM
  • Children
  • MR spectroscopy
  • Multiple sclerosis

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