Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Enzinger, C; Strasser-Fuchs, S; Ropele, S; Kapeller, P; Kleinert, R; Fazekas, F.
Tumefactive demyelinating lesions: conventional and advanced magnetic resonance imaging.
MULT SCLER. 2005; 11: 135-139.
Doi: 10.1191/1352http://dx.doi.org/10.1191/1352458505ms1145oa
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- Führende Autor*innen der Med Uni Graz
- Enzinger Christian
- Co-Autor*innen der Med Uni Graz
- Fazekas Franz
- Fuchs Siegrid
- Kapeller Peter
- Kleinert Reinhold
- Ropele Stefan
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- Abstract:
- In rare instances, demyelinating disorders present with radiological features that mimic a brain tumour. This often leads to biopsy, which--apart from carrying significant morbidity--frequently turns out as nondiagnostic or dispensable. We therefore set out to assess the contribution of repeated conventional magnetic resonance imaging (MRI), 1H-MR spectroscopy and magnetization transfer imaging in establishing a correct diagnosis of tumefactive demyelinating lesions (TDLs). We studied two females and one male, who presented with TDLs that led to brain biopsy in two cases, for up to three years. TDLs were characterized by the following features: (a) delayed or absent response to high-dose steroids together with progressive lesion growth over several weeks; (b) late or sparse enhancement, ill-defined borders, signal inhomogeneity and considerable concomitant oedema; and (c) normalization of initial increases in lipid and lactate peaks within three to four weeks, followed by persistent, marked reductions of the neuronal marker NAA and MTR values around or below 30%. These imaging characteristics reflected the histological correlate of marked demyelination in the absence of significant inflammation. MRI techniques thus appear to have the potential to establish a correct diagnosis of this subtype of TDLs. Awareness of these possibilities might obviate the need for biopsy at least in some cases in future.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adult -
- Brain Neoplasms - pathology
- Demyelinating Diseases - pathology
- Diagnosis, Differential - pathology
- Female - pathology
- Humans - pathology
- Magnetic Resonance Imaging - methods
- Male - methods
- Multiple Sclerosis - pathology
- Protons - pathology
- Find related publications in this database (Keywords)
- acute demyelination
- brain tumour
- demyelinating disease
- MRI
- MRS
- MTR
- multiple sclerosis
- tumefactive lesion