Magnetization transfer imaging provides no evidence of demyelination in methotrexate-induced encephalopathy.
Subacute MTX-induced encephalopathy is characterized by an abrupt onset of focal neurologic deficits within days after intrathecal or systemic therapy. Demyelination is one proposed mechanism. We describe the neuroimaging features of 2 patients with clinical symptoms of subacute encephalopathy after intrathecal and systemic MTX therapy. DWI showed restricted diffusion, indicating cytotoxic edema. MTI yielded no evidence of demyelination in either patient because there was no loss of MTR in areas of restricted diffusion.
Miese
F R
FR
Institute of Radiology, Center for Child and Adolescent Health, Heinrich-Heine-University, Düsseldorf, Germany. falk.miese@med.uni-duesseldorf.de
Schuster
F R
FR
Pierstorff
K
K
Karenfort
M
M
Laws
H J
HJ
Borkhardt
A
A
Saleh
A
A
D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects; D001921:Brain / Q000187:drug effects / Q000473:pathology; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D002648:Child; D003711:Demyelinating Diseases / Q000139:chemically induced / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008727:Methotrexate / Q000009:adverse effects*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate