Abnormal diffusion-weighted magnetic resonance images in Creutzfeldt-Jakob disease

Arch Neurol. 1999 May;56(5):577-83. doi: 10.1001/archneur.56.5.577.


Background: Traditional imaging methods, including computed tomography, routine magnetic resonance imaging (MRI), and magnetic resonance spectroscopy, have not been particularly useful in the diagnosis of Creutzfeldt-Jakob disease (CJD). Although abnormalities can be seen using these methods, the findings are evident only late in the disease or lack specificity or sensitivity.

Objective: To describe abnormalities on diffusion-weighted MRIs in 4 patients with proven CJD.

Methods: Diffusion-weighted MRIs were obtained on 4 patients with CJD as part of a routine MRI brain examination.

Results: In all 4 patients, diffusion-weighted MRIs of the brain demonstrated bilateral hyperintensity in the basal ganglia. In 1 patient, the most conspicuous abnormality seen in diffusion-weighted images was in the thalamus. Two patients also demonstrated hyperintensity in the cerebral cortex on diffusion-weighted images. Only 2 of 4 patients demonstrated clear abnormalities on routine (non-diffusion-weighted) MRIs. Diffusion abnormalities were visible in 1 patient within 1 month of symptom onset. The findings were most conspicuous and extensive in the patient with the longest duration of symptoms (7 months).

Conclusions: Diffusion-weighted MRI might provide a noninvasive method of identifying patients with CJD. However, further investigations must be performed to determine the specificity of these findings for CJD.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Basal Ganglia / pathology*
  • Creutzfeldt-Jakob Syndrome / diagnosis*
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged