Type:
Educational Exhibit
Keywords:
Pathology, Treatment effects, MR, Neuroradiology brain, Haematologic, Haematologic diseases
Authors:
L. Royle, S. Hasso, A. Mazumder, K. Breen; London/UK
DOI:
10.1594/ecr2018/C-2055
Findings and procedure details
Procedure details:
A retrospective study of available Magnetic Resonance Imaging (MRI) brain studies for a cohort of patients with APS established on anticoagulation over a maximum period of 9 years was conducted.
The number of MRIs for individual patients varied and in the vast majority were symptomatically indicated e.g.
headache.
The cases were reviewed by two reporting Radiology Specialty Registrars (StRs) at Guy’s and St Thomas’ Hospital,
London.
If there was a discordance in findings the study was arbitrated by a Consultant Neuroradiologist.
The burden of WMLs was qualitatively graded using the validated Fazekas Scale (3) (Figure 1) and comparison made to previous and subsequent scans.
Complications of treatment or disease progression were also documented.
Findings:
26 cases were reviewed.
The vast majority were female (96%) with a mean age of 45 years.
The average follow up period was 619 days however there was large variations in the follow up periods available. On the initial MRI studies,
31% showed grade 1 WML burden (Figures 2 and 3) and 12% grade 2 (Figures 4 and 5) burden.
Only 8% of cases showed progression in the grade of WML over serial scans.
With regards to the complication rates,
we found 12% had an acute infarct despite being on anticoagulation.
A further 12% had a venous thrombosis and 4% an acute haemorrhage.