title: Quantitative proton MR spectroscopic imaging in acute disseminated encephalomyelitis.
abstract: Serial MR imaging and quantitative proton MR spectroscopic imaging (MRSI) findings of a 4-year-old boy with acute disseminated encephalomyelitis (ADEM) are reported. Over a 2-month period characterized by an initial illness and two relapses, each with full recovery, MR imaging exhibited the appearance and disappearance of multifocal lesions throughout the CNS that correlated only partly with the neurologic impairment. During one relapse, MRSI revealed low levels of N-acetylaspartate (NAA) within the regions of prolonged T2 signal intensity. All other metabolites were normal. At follow-up, the MR imaging and MRSI abnormalities had fully resolved. MRSI might play an important role in the diagnosis of ADEM, as well as in the elucidation of underlying pathophysiologic processes in this poorly defined disorder of children. This case demonstrates that reduced levels of NAA are not always associated with neuronal loss, irreversible tissue damage, or poor neurologic outcome.
authors: Russell C. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, Maryland 21287, USA.
authors: A
authors: A
authors: Bizzi
authors: A M
authors: AM
authors: Uluğ
authors: T O
authors: TO
authors: Crawford
authors: T
authors: T
authors: Passe
authors: M
authors: M
authors: Bugiani
authors: R N
authors: RN
authors: Bryan
authors: P B
authors: PB
authors: Barker
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009460:Neurologic Examination; D011237:Predictive Value of Tests
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate