Diffusion and Perfusion Characteristics of MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episode) in Thirteen Patients
Korean Journal of Radiology
;
: 15-24, 2011.
Article
in English
| WPRIM
| ID: wpr-67057
ABSTRACT
OBJECTIVE:
We analyzed the diffusion and perfusion characteristics of acute MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) lesions in a large series to investigate the controversial changes of the apparent diffusion coefficient (ADC) that were reported in prior studies. MATERIALS ANDMETHODS:
We analyzed 44 newly appearing lesions during 28 stroke-like episodes in 13 patients with MELAS. We performed a visual assessment of the MR images including the ADC and perfusion maps, comparison of the ADC between the normal and abnormal areas, comparison of % ADC between the 44 MELAS lesions and the 30 acute ischemic infarcts. In addition, the patterns of evolution on follow-up MR images were analyzed.RESULTS:
Decreased, increased, and normal ADCs were noted in 16 (36%), 16 (36%), and 12 (27%) lesions, respectively. The mean % ADC was 102 +/- 40.9% in the MELAS and 64 +/- 17.8% in the acute vascular infarcts (p < 0.001), while perfusion imaging demonstrated hyper-perfusion in six acute MELAS lesions. On follow-up images, resolution, progression, and tissue loss were noted in 10, 4, and 17 lesions, respectively.CONCLUSION:
The cytotoxic edema gradually evolves following an acute stroke-like episode in patients with MELAS, and this may overlap with hyper-perfusion and vasogenic edema. The edematous swelling may be reversible or it may evolve to encephalomalacia, suggesting irreversible damage.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Brain
/
Brain Edema
/
MELAS Syndrome
/
Magnetic Resonance Angiography
/
Stroke
/
Diffusion Magnetic Resonance Imaging
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
Korean Journal of Radiology
Year:
2011
Type:
Article
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