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Diffusion and perfusion characteristics of MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) in thirteen patients.
- Source :
-
Korean journal of radiology [Korean J Radiol] 2011 Jan-Feb; Vol. 12 (1), pp. 15-24. Date of Electronic Publication: 2011 Jan 03. - Publication Year :
- 2011
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Abstract
- Objective: We analyzed the diffusion and perfusion characteristics of acute MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) lesions in a large series to investigate the controversial changes of the apparent diffusion coefficient (ADC) that were reported in prior studies.<br />Materials and Methods: We analyzed 44 newly appearing lesions during 28 stroke-like episodes in 13 patients with MELAS. We performed a visual assessment of the MR images including the ADC and perfusion maps, comparison of the ADC between the normal and abnormal areas, comparison of % ADC between the 44 MELAS lesions and the 30 acute ischemic infarcts. In addition, the patterns of evolution on follow-up MR images were analyzed.<br />Results: Decreased, increased, and normal ADCs were noted in 16 (36%), 16 (36%), and 12 (27%) lesions, respectively. The mean % ADC was 102 ± 40.9% in the MELAS and 64 ± 17.8% in the acute vascular infarcts (p < 0.001), while perfusion imaging demonstrated hyper-perfusion in six acute MELAS lesions. On follow-up images, resolution, progression, and tissue loss were noted in 10, 4, and 17 lesions, respectively.<br />Conclusion: The cytotoxic edema gradually evolves following an acute stroke-like episode in patients with MELAS, and this may overlap with hyper-perfusion and vasogenic edema. The edematous swelling may be reversible or it may evolve to encephalomalacia, suggesting irreversible damage.
Details
- Language :
- English
- ISSN :
- 2005-8330
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Korean journal of radiology
- Publication Type :
- Academic Journal
- Accession number :
- 21228936
- Full Text :
- https://doi.org/10.3348/kjr.2011.12.1.15