1. Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement
- Author
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Eva Bültmann, Thomas Lücke, Lars Pape, Xiao-Qi Ding, Jochen H. H. Ehrich, Hans Hartmann, Frank Donnerstag, Heinrich Lanfermann, Jan Zajaczek, Ludwig Hoy, and Anibh M. Das
- Subjects
Diarrhea ,Male ,medicine.medical_specialty ,Pathology ,Neurology ,CNS Involvement ,Gastroenterology ,Age groups ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Child ,Retrospective Studies ,Neuroradiology ,Brain Diseases ,Chi-Square Distribution ,business.industry ,Infant ,General Medicine ,medicine.disease ,humanities ,Uremia ,body regions ,Diffusion Magnetic Resonance Imaging ,Child, Preschool ,Hemolytic-Uremic Syndrome ,Female ,Radiology ,Haemolytic-uraemic syndrome ,business ,Diffusion MRI - Abstract
Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively.DWI within 24 h of onset of neurological symptoms. The apparent diffusion coefficient (ADC) was measured in grey/white matter and correlated with clinical and laboratory findings.DWI was abnormal in all. Abnormal ADC was detected in the supratentorial white matter (6/12) and cortex (1/12), the basal ganglia (5/12), the thalami (4/12), and the cerebellum (1/12). ADC was reduced in 5/12, increased in 4/12, and both in 3/12. Mean serum sodium was lower in patients with DWI abnormalities affecting the white matter (6/12), than in those with basal ganglia/thalamic involvement (6/12). Neurological outcome was normal in 4/11 and abnormal in 7/11, and 1 patient died, outcome did not correlate to either localisation or type of DWI abnormality.In D+HUS with neurological symptoms, early DWI may reveal abnormal ADC not only in the basal ganglia/thalami, but also in the white matter/cortex. Besides thrombotic microangiopathy, toxic effects of shiga toxin, azotaemia and hyponatraemia / hypoosmolality may be involved in cerebral involvement in children with D+HUS. Findings on early MRI seem not to predict clinical course or outcome.• DWI MR imaging may detect early CNS involvement in haemolytic uraemic syndrome • Different pathogenetical mechanisms may contribute to the CNS disease in HUS • Early MRI findings do not seem to allow prediction of clinical outcome.
- Published
- 2011
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