title: Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI.
abstract: BACKGROUND
  Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI.
  
  
  METHODS
  In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls.
  
  
  RESULTS
  Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01).
  
  
  CONCLUSIONS
  Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes.
authors.affiliation: Clinic for Neurology, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany. weissenborn.karin@mh-hannover.de
authors.forename: Karin
authors.initials: K
authors.lastname: Weissenborn
authors.forename: Eva
authors.initials: E
authors.lastname: Bültmann
authors.forename: Frank
authors.initials: F
authors.lastname: Donnerstag
authors.forename: Anja M
authors.initials: AM
authors.lastname: Giesemann
authors.forename: Friedrich
authors.initials: F
authors.lastname: Götz
authors.forename: Hans
authors.initials: H
authors.lastname: Worthmann
authors.forename: Meike
authors.initials: M
authors.lastname: Heeren
authors.forename: Jan
authors.initials: J
authors.lastname: Kielstein
authors.forename: Anke
authors.initials: A
authors.lastname: Schwarz
authors.forename: Heinrich
authors.initials: H
authors.lastname: Lanfermann
authors.forename: Xiao-Qi
authors.initials: XQ
authors.lastname: Ding
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
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