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Review of dis­eases with restricted dif­fusion on magnetic resonance imag­­ing of the brain


Authors: Z. Sedláčková 1;  T. Dorňák 2;  E. Čecháková 1;  S. Buřval 1;  M. Heřman 1
Authors place of work: Radiologická klinika LF UP a FN Olomouc 1;  Neurologická klinika LF UP a FN Olomouc 2
Published in the journal: Cesk Slov Neurol N 2018; 81(5): 539-545
Category: Přehledný referát
doi: https://doi.org/10.14735/amcsnn2018539

Summary

There are a lot of dis­eases that can show restricted dif­fusion on brain MRI. While it is almost always present in some of them, it can be seen only occasional­ly in others, in which case it is usual­ly as­sociated with a more severe prognosis. Additional MRI sequences and clinical presentation aid in the dif­ferential dia­gnosis. The aim of this review is to enlist and describe dis­eases that can present with restricted dif­fusion on brain MRI. Restricted dif­fusion is most often found in acute ischemia and it is also typical­ly present in an abscess or empyema as well as in lymphomas and Creutzfeldt-Jacob dis­ease. It can also be found in highly cel­lular tumors, certain metastases, dif­fuse axonal injury, acute dis­seminated encephalomyelitis, encephalitis, posterior reversible encephalopathy syndrome, Wernicke’s encephalopathy, Marchiafava-Bignami syndrome, osmotic demyelination syndrome, hypo-/ hyperglycemia, Rathke’s cleft cysts, acute-stage Wilson’s dis­ease, carbon monoxide poisoning, and, rarely, in MS and epilepsy. Restricted dif­fusion is as­ses­sed on dif­fusion-weighted images (DWI). It can only be valid in the case of a simultaneous find­­ing of a hypersignal area on DWI with a higher b value (usual­ly b = 1,000) and of a hyposignal area in the same location on apparent dif­fusion coef­ficient maps.

Key words:
magnetic resonance imaging – diffusion magnetic resonance imaging – brain ischemia – brain abscess – brain neoplasms

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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