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Author Cherian, Ajith ♦ Thomas, Bejoy ♦ Baheti, N. N. ♦ Chemmanam, T. ♦ Kesavadas, C.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Journal of Magnetic Resonance Imaging
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Nutritional and Metabolic Diseases ♦ Diseases ♦ Diagnosis ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment
Subject Keyword Radiology
Abstract Hyperglycemia-induced hemichorea can show T1 hyperintensity of the contralateral striatum on MRI. This is thought to be due to petechial hemorrhages or gemistocytic astrocyte accumulation. This study explores the utility of susceptibility-weighted imaging (SWI) and diffusion-weighted imaging (DWI) in identifying the nature of these lesions. Three patients underwent MR imaging of the brain with SE T1, F SE T2. DWI, and SWI. T1 images showed hyperintensity predominantly involving the contralateral striatum, where mild (two cases) to moderate (one case) restricted diffusion (low apparent diffusion coefficient [ADC]) was detected on DWI. SWI demonstrated bilateral symmetrical hypointensities in the first two cases, suggesting age associated mineralization. In addition, increased susceptibility change (hypointensity) was also noted in the right putamen in the first and the third cases, suggesting paramagnetic mineral deposition. T1 hyperintensity may be from the protein hydration layer inside the cytoplasm of swollen gemistocytes appearing after an acute cerebral injury. These astrocytes also express metallothionein with zinc, which is thought to be the cause of asymmetric hypointensity of the posterior putamen on SWI. ADC values were thought to be useful for prognostication: however, they should be interpreted cautiously in the presence of susceptibility changes.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Journal Journal of Magnetic Resonance Imaging
Volume Number 29
Issue Number 3
Page Count 5
Starting Page 699
Ending Page 703