Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience - 28/08/11
, Claudia C Leite, MD a, Soubhi Kahhale, MD b, Sálvio Freire, MD d, Benesson Sousa, MD c, Ellison F Cardoso, MD a, Eliane A Alves, MD b, Paulo Borba, MD c, Giovanni G Cerri, MD a, Marcelo Zugaib, MD b
Reprint requests: Ricardo Loureiro, MD, Department of Radiology, Federal University of Pernambuco, Fernando Simo̧es Barbosa St, 602/401, 51021060, Recife, PE, Brazil.Sao Paulo and Pernambuco, Brazil
Abstract |
Objective |
The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia.
Study design |
Seventeen patients with a clinical diagnosis of severe eclampsia/preeclampsia and T2 hyperintense brain lesions on routine magnetic resonance imaging were evaluated at hospital admission and 8 weeks later.
Results |
Brain edema was reversible in 13 patients and irreversible in 4 patients, as indicated on follow-up magnetic resonance imaging. Sixteen of 17 patients were differentiated accurately into reversible and irreversible groups on the basis of diffusion imaging on hospital admission. Diffusion-weighted magnetic resonance imaging demonstrated a significant increase in water mobility in abnormal regions compared with normal-appearing brains in patients in the reversible group (1.34±0.10 mm2 vs 0.79±0.08 mm2/s×10−3, P<.001). In the irreversible group, restricted water diffusion was present, which was consistent with cytotoxic edema and early brain infarction in 3 of 4 patients.
Conclusion |
Diffusion-weighted magnetic resonance imaging can predict successfully the evolutive course of brain edema in an acute setting in these patients. Our findings indicate that brain edema is vasogenic, although ischemic/cytotoxic edema was observed less commonly.
Le texte complet de cet article est disponible en PDF.Keywords : Eclampsia, posterior leukoencephalopathy syndrome, diffusion imaging, brain edema, magnetic resonance imaging
Plan
 | Supported in part by Coordenação de Aperfeiçoamento de Pessoal de Nı́vel (CAPES)—BRAZIL (R. L.). |
Vol 189 - N° 5
P. 1350-1355 - novembre 2003 Retour au numéro
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