EURORAD ESR

Case 11666

Acute methotrexate-induced leukoencephalopathy: MRI findings

Author(s)
Moliné T, Fernández Drago L, Docampo J, Nápoli A, Castillo C, Morales C.

Fundación Científica del Sur
Imaging Diagnosis
Av Hipólito Yrigoyen 8680
1832 Lomas de Zamora
Buenos Aires, Argentina
Email:moline.tomas@gmail.com
 
Patient
female, 10 year(s)
 
 
  • Figure 1
    DWI and ADC maps

    There is restricted diffusion on both centrum semiovale (A) and both corona radiata (B). The splenium of corpus callosum is also involved (C). ADC maps confirm these findings (D, E, F).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Drugs / Reactions;
     
     
  • Figure 2
    T2 and FLAIR-weighted images

    Lesions are hyperintense on T2-weighted images (A, B, C). Flair only shows mild ring hyperintensity on both corona radiata (D, E, F).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Leukaemia;
     
     
  • Figure 3
    T1-weighted images before and after gadolinium injection

    On T1-weighted images corresponding areas are iso to hypointense (A, B, C), with no evident enhancement after gadolinium administration (D, E, F).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 4
    Follow-up: DWI and ADC maps

    Both centrum semiovale (A), corona radiatas (B) and splenium of corpus callosum (C) show mild T2-effect on DWI. ADC maps depict no evident restricted diffusion (D, E, F).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Drugs / Reactions;
     
     
  • Figure 5
    Follow-up: T2 and FLAIR-weighted images

    Areas of gliosis are seen on follow-up T2 (A, B, C) and FLAIR (D, E, F).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Drugs / Reactions;
     
     
There is restricted diffusion on both centrum semiovale (A) and both corona radiata (B). The splenium of corpus callosum is also involved (C). ADC maps confirm these findings (D, E, F).
 
Lesions are hyperintense on T2-weighted images (A, B, C). Flair only shows mild ring hyperintensity on both corona radiata (D, E, F).
 
On T1-weighted images corresponding areas are iso to hypointense (A, B, C), with no evident enhancement after gadolinium administration (D, E, F).
 
Both centrum semiovale (A), corona radiatas (B) and splenium of corpus callosum (C) show mild T2-effect on DWI. ADC maps depict no evident restricted diffusion (D, E, F).
 
Areas of gliosis are seen on follow-up T2 (A, B, C) and FLAIR (D, E, F).
 
 
 
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