Rebound After Fingolimod and a Single Daclizumab Injection in a Patient Retrospectively Diagnosed With NMO Spectrum Disorder-MRI Apparent Diffusion Coefficient Maps in Differential Diagnosis of Demyelinating CNS Disorders.

Wagner, Franca; Grunder, Lorenz Nicolas; Hakim, Arsany; Kamber, Nicole; Horn, Michael; Müllner, Julia Nicole Maria; Hoepner, Robert; Wiest, Roland; Metz, Imke; Chan, Andrew; Salmen, Anke (2018). Rebound After Fingolimod and a Single Daclizumab Injection in a Patient Retrospectively Diagnosed With NMO Spectrum Disorder-MRI Apparent Diffusion Coefficient Maps in Differential Diagnosis of Demyelinating CNS Disorders. Frontiers in neurology, 9(782), p. 782. Frontiers Media S.A. 10.3389/fneur.2018.00782

[img]
Preview
Text
fneur-09-00782.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

Differential diagnosis of neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) or mimics can be challenging, especially in patients with atypical presentations and negative serostatus for aquaporin-4 antibodies (AQP4-Ab). This brief research report describes magnetic resonance imaging (MRI) findings focusing on quantitative apparent diffusion coefficient (ADC) histogram analysis as a potential tool to differentiate NMOSD from MS. Longitudinal MRI data obtained during routine clinical examinations were retrospectively analyzed in a patient with histologically determined cerebral NMOSD, a patient with an acute tumefactive MS lesion, and a patient with ischemic stroke. Histogram analyses of ADC maps were evaluated. A patient diagnosed with MS experienced a severe rebound after fingolimod withdrawal and a single daclizumab injection. Cerebral NMOSD manifestation was confirmed by brain biopsy. However, the patient did not fulfill consensus criteria for NMOSD and was AQP4-Ab negative. Comparison of ADC histogram analyses of this patient with those from a patient with MS and one with ischemic stroke revealed differential ADC characteristics: namely a more pronounced and prolonged ADC leftward shift in inflammatory than in ischemic pathology, even more accentuated in NMOSD versus MS. ADC map histograms and ADC threshold values for different conditions may be useful for differentiation of large inflammatory brain lesions and further studies are merited.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Wagner, Franca; Grunder, Lorenz Nicolas; Hakim, Arsany; Kamber, Nicole; Horn, Michael; Müllner, Julia Nicole Maria; Hoepner, Robert; Wiest, Roland; Chan, Andrew and Salmen, Anke

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

22 Oct 2018 09:52

Last Modified:

28 Oct 2018 02:33

Publisher DOI:

10.3389/fneur.2018.00782

PubMed ID:

30319524

Uncontrolled Keywords:

ADC MRI MS NMOSD histogram analysis multiple sclerosis neuromyelitis optica

BORIS DOI:

10.7892/boris.120554

URI:

https://boris.unibe.ch/id/eprint/120554

Actions (login required)

Edit item Edit item
Provide Feedback