Neuro-Behcet's disease: diffusion MR imaging and proton MR spectroscopy.
We herein report the case of a 53-year-old woman with Behcet's disease and an acute T2-hyperintense lesion in left side of the pons. Echo-planar "trace" diffusion MR imaging revealed high signal intensity changes at the lesion site on b = 1000 s/mm(2) images, initially suggesting restricted diffusion. On corresponding apparent diffusion coefficient maps, however, the lesion had high signal intensity and high apparent diffusion coefficient values (1.22 x 10(-3) mm(2)/s), compared with the contralateral normal side of the pons (0.86 x 10(-3) mm(2)/s) and compared with the normal temporal white matter (0.80 x 10(-3) mm(2)/s). This was consistent with the presence of increased diffusion, hence vasogenic edema. Proton MR spectroscopy excluded acute infarction. This particular pattern (high signal intensity on b = 1000 s/mm(2) images in association with high apparent diffusion coefficient values) likely represented the acute inflammatory process associated with disrupted brain-blood barrier in the fulminant form of neuro-Behcet's disease. Follow-up examinations </=2 years later revealed a remaining gliotic lesion.
D001528:Behcet Syndrome / Q000175:diagnosis*; D001929:Brain Edema / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D005911:Gliosis / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D011149:Pons / Q000098:blood supply* / Q000473:pathology; D012680:Sensitivity and Specificity; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis*