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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleBrain

Early- and Late-State Subacute Sclerosing Panencephalitis: Chemical Shift Imaging and Single-Voxel MR Spectroscopy

Alpay Alkan, Kaya Sarac, Ramazan Kutlu, Cengiz Yakinci, Ahmet Sigirci, Mehmet Aslan and Tamer Baysal
American Journal of Neuroradiology March 2003, 24 (3) 501-506;
Alpay Alkan
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Kaya Sarac
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Ramazan Kutlu
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Cengiz Yakinci
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Ahmet Sigirci
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Mehmet Aslan
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Tamer Baysal
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    Fig 1.

    Findings in a 6-year-old girl with stage II SSPE.

    A, Axial T2-weighted localizer image (2875/120) shows a 2 × 2 × 2-cm voxel placed in the left FSWM.

    B, MR spectrum (single voxel, PRESS; 2000/31/256) shows a normal NAA/Cr ratio and increased Cho/Cr and MI/Cr ratios.

  • Fig 2.
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    Fig 2.

    Findings in an 8-year-old girl with stage II SSPE.

    A, Axial T2-weighted image (4530/100) shows normal brain parenchymal findings.

    B, Coronal T2-weighted localizer image (2875/120) shows a 2 × 2 × 2-cm voxel placed in the left POWM.

    C, MR spectrum (single voxel, PRESS; 2000/31/256) shows a normal NAA/Cr ratio and increased Cho/Cr and MI/Cr ratios.

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    Fig 3.

    Findings in an 8-year-old boy with stage III SSPE.

    A, Coronal T2-weighted image (4530/100) shows periventricular hyperintensities and cerebral and brain stem atrophy.

    B, Axial T2-weighted localizer image (2875/120) shows a 2 × 2 × 2-cm voxel placed in the left POWM.

    C, MR spectrum (single voxel, PRESS; 2000/31/256) shows a substantially decreased NAA/Cr ratio, increased Cho/Cr, Ins/Cr ratios, and lipid and lactate peaks.

  • Fig 4.
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    Fig 4.

    Findings in a 7-year-old girl with stage III SSPE.

    A, CSI map of NAA shows decreased NAA signal intensity in the FSWM (straight arrows) and POWM (curved arrows).

    B, Axial T2-weighted localizer image (2875/120) for MVS shows periventricular hyperintensities and cerebral atrophy.

    C, MR spectrum (1500/136) (1) shows a normal NAA/Cr ratio and increased Cho/Cr ratios in left periventricular white matter. MR spectrum (2) shows substantially decreased NAA/Cr and increased Cho/Cr ratios in the left POWM.

  • Fig 5.
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    Fig 5.

    Findings in an 8-year-old boy with stage III SSPE.

    A, Coronal T2-weighted image (4530/100) shows periventricular hyperintensities and cerebral atrophy.

    B, CSI map of Cho shows increased Cho signal intensity in the left periventricular white matter (arrows).

    C, Axial T2-weighted localizer image (2875/120) for MVS shows diffuse periventricular hyperintensities and cerebral atrophy.

    D, MR spectrum (1500/136) (3) shows significantly decreased NAA/Cr and increased Cho/Cr ratios in the left POWM.

Tables

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    TABLE 1:

    Demographic, clinical, and imaging features of SSPE cases

    Patient/Age, y/SexVaccinationAge at Measles InfectionTime after DiagnosisStage at DiagnosisClinical and Neurologic FindingsMRI Findings
    Stage II at MRS
     1/8/FNo7 mo1 yIIChoreoathetosis, myoclonus, difficulty speaking, tonic convulsion, mental deteriorationNormal
     2/8/MYesNA*6 moIIMyoclonus, ataxia, spasticity, tonic-clonic seizures, difficulty speakingNormal
     3/6/FYes12 mo9 moIIMyoclonus, ataxia, mental deterioration, walking with assistanceNormal
    Stage III at MRS
     1/8/MYes11 mo4 yIINo speech, decerebrate rigidity, bedridden, no responsiveness to any stimulusCerebral, cerebellar, and brainstem atrophy, periventricular hyperintensities
     2/8/MNo6 mo3 yIINo speech, opisthotonos, decerebrate and decorticate rigidity, no responsiveness to any stimulus, bedriddenCerebral and cerebellar atrophy, periventricular hyperintensities
     3/7/FYes16 mo2 yIIDecerebrate rigidity, bedridden, no speechCerebral and cerebellar atrophy, periventricular hyperintensities
    • * Not applicable.

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    TABLE 2:

    Mean metabolite ratios

    SubjectsNAA/CrCho/CrMI/CrNAA/Cho
    FSWMPOWMFSWMPOWMFSWMPOWMFSWMPOWM
    Stage II SSPE1.62 ± 0.031.56 ± 0.051.05 ± 0.01*1.15 ± 0.07*1.42 ± 0.15*1.34 ± 0.01*1.55 ± 0.16*1.36 ± 0.13*
    Stage III SSPE1.08 ± 0.22*0.91 ± 0.17*1.43 ± 0.19*1.33 ± 0.23*2.35 ± 0.09*2.66 ± 0.10*0.75 ± 0.18*0.68 ± 0.04*
    Control1.74 ± 0.121.69 ± 0.190.64 ± 0.110.66 ± 0.120.66 ± 0.110.63 ± 0.122.78 ± 0.502.59 ± 0.50
    • Note.—Data are the mean ± SDs.

    • * P < .01 versus control group.

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American Journal of Neuroradiology: 24 (3)
American Journal of Neuroradiology
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Early- and Late-State Subacute Sclerosing Panencephalitis: Chemical Shift Imaging and Single-Voxel MR Spectroscopy
Alpay Alkan, Kaya Sarac, Ramazan Kutlu, Cengiz Yakinci, Ahmet Sigirci, Mehmet Aslan, Tamer Baysal
American Journal of Neuroradiology Mar 2003, 24 (3) 501-506;
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Alpay Alkan, Kaya Sarac, Ramazan Kutlu, Cengiz Yakinci, Ahmet Sigirci, Mehmet Aslan, Tamer Baysal
Early- and Late-State Subacute Sclerosing Panencephalitis: Chemical Shift Imaging and Single-Voxel MR Spectroscopy
American Journal of Neuroradiology Mar 2003, 24 (3) 501-506;

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