Serial diffusion-weighted imaging in MELAS |
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Authors: | T Ohshita M Oka Y Imon C Watanabe S Katayama S Yamaguchi T Kajima Y Mimori S Nakamura |
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Institution: | (1) Third Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan e-mail: ohshitat@mcai.med.hiroshima-u.ac.jp Tel.: + 81-82-2 57-52 01 Fax: + 81-82-5 05-04 90, JP |
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Abstract: | Clinical features of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) resemble those
of cerebral infarcts, but the pathogenesis of infarct-like lesions is not fully understood. To characterise these infarct-like
lesions, we studied two patients with MELAS using diffusion-weighted (DWI) MRI before and after stroke-like episodes and measured
the apparent diffusion coefficient (ADC) in the new infarct-like lesions. These gave high signal on DWI and had much higher
ADC than normal-appearing regions. The ADC remained high even 30 days after a stroke-like episode then decreased in lesions,
with or without abnormality as shown by conventional MRI. We speculate that early elevation of ADC in the acute or subacute
phase reflects vasogenic rather than cytotoxic edema. The ADC of the lesions, which disappeared almost completely with clinical
improvement, returned to normal levels, which may reflect tissue recovery without severe damage. To our knowledge, this is
the first study of DWI in MELAS.
Received: 13 September 1999/Accepted: 7 January 2000 |
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Keywords: | Mitochondrial cytopathy Magnetic resonance imaging diffusion-weighted |
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