ECR 2006 / C-640
Diffusion-MR imaging usefulness in the differential diagnosis of acute leukoencephalopathy in children during treatment of haematological malignancies
Authors:
E. Marco de Lucas, K. González Mandly, S. Sánchez, S. Gutiérrez, C. Díez, M. Pelaz, G. Blanco, R. Pellón, J. Jordá; Santander/ES
Conclusion
- Include always a diffusion sequence in your MR studies of patients with a possible leukoencephalopathy! (if you don't use it in all of your patients)
- Acute methotrexate neurotoxicity is a rare transient encephalopathy encountered after 1 week of MTX medication, resolving spontaneously within few days.
- DWI and ADC allow a more confident recognition and differential diagnosis in patients with suspected acute methotrexate neurotoxicity, because identifies areas of white matter injury before lesions are detectable with other standard sequences.
- Restricted diffusion does not mean necessarily permanent lesion and should not be considered an indication to stop intrathecal MTX.