Brain magnetic resonance imaging does not contribute to the diagnosis of chronic neuroborreliosis.
BACKGROUND
Borrelia infections, especially chronic neuroborreliosis (NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive.


OBJECTIVE
To evaluate brain magnetic resonance imaging (MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration.


METHODS
Sixteen well-characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- (with and without gadolinium), T2-, and diffusion-weighted imaging plus fluid-attenuated inversion recovery (FLAIR) imaging were used.


RESULTS
White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls (no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients (rho = 0.83, P<0.01) and in controls (rho = 0.61, P<0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2-weighted imaging.


CONCLUSIONS
A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.
Aalto
A
A
Division of Radiology, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden. anne.aalto@imv.liu.se
Sjöwall
J
J
Davidsson
L
L
Forsberg
P
P
Smedby
O
O
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013997:Time Factors