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We analysed 36 patients and 57 controls. VCJD patients were correctly identified based on bilateral pulvinar high signal in 29 of 36 and 32 of 36 cases on the first assessment by the two radiologists, and 32 of 36 and 31of 36 on their second assessment. Bilateral increased pulvinar signal was identified in one of 57 and one of 57 controls on the first assessment and two of 57 and three of 57 controls on the second assessment. These reported changes in controls were graded as minimal/equivocal in six of seven patients and moderate in on (<0.5% of all control assessments). 80% of the assessments in vCJD cases were graded as moderate or substantial. On consensus review, 29 of 36 cases and none of 57 controls had prominent bilateral pulvinar signal - sensitivity 78% (95% CI 60-90%) and specificity 100% (95% CI 94-100%). Other common MRI features of vCJD were medial thalamic and periaqueductal grey matter high signal, and the notable absence of cerebral atrophy. Pulvinar high signal correlated with histological gliosis. In the appropriate clinical context the MRI identification of bilaterally increased pulvinar signal is a useful non-invasive test for the diagnosis of vCJD. |
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gliosis
Jakob-Creutzfeldt disease
Jakob-Creutzfeldt disease,variant
MRI
MRI,abnormal
MRI,false positive
MRI,high signal foci on
MRI,high signal intensity of basal ganglia
neurologic disease,diagnoses of
pulvinar sign
thalamus,lesion of
thalamus,lesion of-bilateral
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