title: MR diagnosis of Creutzfeldt-Jakob disease: significance of high signal intensity of the basal ganglia.
abstract: OBJECTIVE
  Creutzfeldt-Jakob disease is a rare dementing illness that usually affects older adults. Currently, neuroradiologic examinations play a minor role in the diagnosis of Creutzfeldt-Jakob disease. Several single case reports have noted a distinctive finding of hyperintense signal abnormalities in the basal ganglia on T2-weighted MR images of patients with Creutzfeldt-Jakob disease. In order to assess the diagnostic utility of this finding, we studied the imaging features of four patients with Creutzfeldt-Jakob disease in whom this MR finding was present.
  
  
  METHODS
  Two neuroradiologists retrospectively reviewed the MR images of four patients who had pathologically proved Creutzfeldt-Jakob disease and signal abnormalities in the basal ganglia on T2-weighted MR images. The patients' clinical findings were also analyzed.
  
  
  RESULTS
  The four patients had MR examinations between 6 months and 1 year after the onset of symptoms. In all four cases, the hyperintense signal abnormalities in the basal ganglia on T2-weighted images were diffuse and bilaterally symmetric. The T1-weighted images were normal. A CT scan was obtained on a single patient and was normal.
  
  
  CONCLUSIONS
  Although a lack of signal abnormality in the basal ganglia on MR imaging cannot be used to rule out a diagnosis of Creutzfeldt-Jakob disease, our experience and review of published reports suggest that in the proper clinical setting, bilaterally symmetric, diffuse hyperintense abnormalities in the basal ganglia on T2-weighted images may be a specific sign of Creutzfeldt-Jakob disease.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston 02114.
authors.forename: D P
authors.initials: DP
authors.lastname: Barboriak
authors.forename: J M
authors.initials: JM
authors.lastname: Provenzale
authors.forename: O B
authors.initials: OB
authors.lastname: Boyko
mesh_terms: D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000473:pathology*; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies