Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt–Jakob disease

摘要: Objective: To evaluate the usefulness of diffusion-weighted MRI (DWI) for early diagnosis Creutzfeldt–Jakob disease (CJD). Methods: Thirty-six consecutive patients (age 56 to 82 years) were enrolled, and 26 examined by DWI. Nine definite based on World Health Organization criteria, 27 probable. The percentages DWI abnormalities, periodic sharp wave complexes (PSWCs) EEG, detection CSF 14-3-3 protein, increase neuron-specific enolase (>25 ng/mL) first examination compared. For DWI, 32 31 84 who showed progressive dementia or impaired consciousness served as controls. Results: percentage abnormalities was 92.3%, PSWCs 50.0%, protein 84.0%, NSE 73.3%. Two control subjects falsely positive sensitivity 92.3% (95% CI 74.8 99.5%) specificity 93.8% 79.2 99.2%). In 17 did not show abnormal findings still clearly detected. Four negative also abnormalities. detected at 3 weeks symptom duration in four whom yet evident. Conclusions: can detect characteristic lesions majority with CJD regardless presence PSWCs. most sensitive test clinical CJD; consideration should be given its inclusion diagnostic criteria CJD.