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  • Title: [Creutzfeldt-Jakob disease: value of MRI].
    Author: Urbach H, Paus S, Tschampa HJ, Keller E, Schild HH.
    Journal: Rofo; 2001 Jun; 173(6):509-14. PubMed ID: 11471291.
    Abstract:
    PURPOSE: To define the role of MRI in the diagnosis of Creutzfeldt-Jakob disease (CJD). METHODS: 14 patients with suspected CJD were studied within 3 years. MRI findings were correlated with WHO established diagnostic criteria (clinical findings, EEG, CSF with 14-3-3 protein assay). RESULTS: 12 patients had CJD. One patient each suffered from Hashimoto's encephalitis and ALS dementia complex, respectively. Nine of 12 CJD patients had increased signal intensity of the striatum (n = 8), pulvinar thalami (n = 5) and/or cerebellar and cerebral cortex (n = 3), respectively. Signal intensity was most pronounced on FLAIR sequences; six patients were studied with diffusion-weighted MRI and showed impaired diffusion in these areas. Both patients without CJD did not show the abovementioned signal changes (sensitivity 75%, specificity and positive predictive value 100%, respectively). CONCLUSION: If patients with suspected CJD are studied with FLAIR and diffusion-weighted sequences, this disorder can reliably be proven or ruled out. Typical MRI findings narrow down the differential diagnosis and should be included in the WHO diagnostic criteria.
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