Akbaş T.

XVI.Balkan Congress of Radiology 2018, İzmir, Turkey, 4 - 06 October 2018, pp.82-83

  • Publication Type: Conference Paper / Summary Text
  • City: İzmir
  • Country: Turkey
  • Page Numbers: pp.82-83
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes


Introduction: Posterior reversible encephalopathy syndrome

(PRES) often associated with hypertension is characterized by typical

transient parieto-occipital brain predominantly vasogenic and occasionally

cytotoxic edema on magnetic resonance imaging (MRI) with

neurological symptoms. Cerebral hyperperfusion by exceeding the

capacity for cerebral blood flow autoregulation of systemic hypertension

and cerebral hypoperfusion related to disruption of blood-brain

barrier are contradictory hypothesis of PRES pathophysiology.

Purpose: It’s aimed that increased apparent diffusion coefficent

(ADC) values on diffusion weighted imaging (DWI) may be more

sensitive to edema than findings on fluid attenuation inversion recovery

(FLAIR) images and normal looking brain regions are vulnerable

to PRES.

Materials and Methods: A total of 32 pediatric hematology

and oncology patients (14 male, 18 female, aged 3-18, mean age:

10,6±4,7 years) diagnosed with PRES during treatment and after

hematopoietic stem cell transplantation (HSCT) and 32 healthy children

with a normal MRI study as control group were correlated in

this retrospective study. The presence of brain edema evaluated on

FLAIR sequence, region of interest (ROI) were systematically placed

and the mean ADC values were measured on DWI according to

nineteen specified anatomical regions including typical and atypical

involvement. Diffusion restriction and hemorrhage were also noted.

Results: There was no statistically significant difference between

age and sex distributions of control and PRES groups (p>0.05). The

mean ADC values of PRES group were statistically significantly higher

than control group at typical involvement regions (p<0.05). The

mean ADC values of PRES group did not differ statistically according

to the presence of PRES except right lentiform nucleus and left

caudat nucleus.

Conclusions: Our results suggest that quantitative DWI MR of

brain edema provides complemental information that ‘normal-looking’

brain regions on FLAIR images showed a tendency to have

higher ADC values in pediatric PRES.

Keywords: Posterior reversible encephalopathy syndrome (PRES), Magnetic

Resonance Imaging (MRI), Apparent diffusion coefficent (ADC), Children,

Brain edema