title: Use of diffusion-weighted imaging in recurrent central nervous system Whipple's disease: a case report and review of the literature.
abstract: A case of Whipple's disease with development of antibiotic resistance is reported. The patient's symptomatology correlated with evolution of diffusion abnormality rather than with lesion enhancement. The lesion demonstrated no hyperperfusion, moderately elevated choline, and decreased N-acetylaspartate. Conventional magnetic resonance (MR) imaging findings of central nervous system Whipple's disease are nonspecific and may mimic neoplasm. MR perfusion and spectroscopy findings are reported, which may assist in diagnosis. Change in diffusion restriction appears to be a potential imaging indicator of clinical progression and response to therapy.
authors.affiliation: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467-2401, USA.
authors.forename: Amit A
authors.initials: AA
authors.lastname: Raheja
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Lui
authors.forename: Alberto
authors.initials: A
authors.lastname: Pinzon-Ardila
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Lim
authors.forename: Steven A
authors.initials: SA
authors.lastname: Sparr
mesh_terms: D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004660:Encephalitis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D008061:Whipple Disease / Q000175:diagnosis*