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01-03-2012 | Neuro

Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement

Authors: Frank Donnerstag, Xiaoqi Ding, Lars Pape, Eva Bültmann, Thomas Lücke, Jan Zajaczek, Ludwig Hoy, Anibh Martin Das, Heinrich Lanfermann, Jochen Ehrich, Hans Hartmann

Published in: European Radiology | Issue 3/2012

Abstract

Objectives

Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively.

Methods

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.

Results

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.

Conclusions

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.

Key Points

• 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

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Title: Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement
Authors: Frank Donnerstag
Xiaoqi Ding
Lars Pape
Eva Bültmann
Thomas Lücke
Jan Zajaczek
Ludwig Hoy
Anibh Martin Das
Heinrich Lanfermann
Jochen Ehrich
Hans Hartmann
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 3/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2286-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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