Serial proton MR spectroscopy and diffusion tensor imaging in infantile Balo's concentric sclerosis.
BACKGROUND
Proton magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) yield different parameters for characterizing the evolution of a demyelinating white matter disease. The purpose was to elucidate biochemical and microstructural changes in Balo's concentric sclerosis lesions and to correlate the findings with the clinical course.


METHODS
Localized short-echo time MRS and DTI were performed over 6 years in a left occipital lesion of a female patient (age at onset 13.8 years) with Balo's concentric sclerosis. A right homonym hemianopsia persisted.


RESULTS
Metabolite patterns were in line with initial active demyelination followed by gliosis and partial recovery of neuroaxonal metabolites. Fractional anisotropy and mean diffusivity of tissue water remained severely altered. Fiber tracking confirmed a disruption in the geniculo-calcarine tract as well as involvement of the corpus callosum.


CONCLUSIONS
MRS and DTI depict complementary parameters, but DTI seems to correlate better with clinical symptoms.
Dreha-Kulaczewski
Steffi F
SF
Department of Pediatrics and Pediatric Neurology, Georg August University, Göttingen, Germany. sdreha@gwdg.de
Helms
Gunther
G
Dechent
Peter
P
Hofer
Sabine
S
Gärtner
Jutta
J
Frahm
Jens
J
D000293:Adolescent; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D011522:Protons; D014018:Tissue Distribution
D011522:Protons