1H-MRS for the diagnosis of acute disseminated encephalomyelitis: insight into the acute-disease stage.
BACKGROUND
Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder of the central nervous system (CNS). Differentiating ADEM from other inflammatory disorders, such as multiple sclerosis, is not always conclusive using conventional MRI.


OBJECTIVE
To evaluate longitudinal magnetic resonance spectroscopy (MRS) changes that distinguish ADEM from other inflammatory disorders.


METHODS
MRI/MRS scans were performed in seven patients with ADEM during the acute and chronic phases of the disease.


RESULTS
Partial recovery was detected between the acute and chronic phases in choline/creatine ratio. Major elevation of lipids and reduction in myo-inositol/creatine ratio was detected in all patients during the acute phase, followed by a reduction in lipids peak and elevation above normal in myo-inositol/creatine ratio during the chronic phase.


CONCLUSIONS
Consistent and unique MRS changes in metabolite ratios between the acute and chronic presentations of the disease were found. To the best of our knowledge, these patterns have not been described in other inflammatory disorders and might assist in the early diagnosis of ADEM.
Department of Radiology, Tel Aviv Sourasky Medical Center, Tel-Aviv, 64239, Israel.
Liat
L
Ben Sira
Elka
E
Miller
Moran
M
Artzi
Aviva
A
Fattal-Valevski
Shlomi
S
Constantini
Dafna
D
Ben Bashat
D000208:Acute Disease; D000293:Adolescent; D015415:Biomarkers / Q000032:analysis*; D001921:Brain / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D011522:Protons
D015415:Biomarkers; D011522:Protons