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Rasmussen encephalitis

Case Study
Kovanlikaya, Ilhami Istanbul, Yeditepe University Hospital Turkey

Patient history:

A 19-year-old male presented with intractable seizures.

MR examination:

A pre and post surgical MRI examination of the brain was performed using the Achieva 3.0T system with Quasar Dual gradients.

MR images and interpretation:

Pre-surgical:

T1-weighted axial T2-weighted TSE coronal DTI fiber tractography
T1-weighted axial
T2-weighted TSE coronal
DTI fiber tractography
Postprocessed fMRI images of left lower extremity motor task
Postprocessed fMRI images of left lower extremity motor task

 

Both the T1-weighted axial image and the T2-weighted TSE coronal image demonstrates necrosis and significant atrophy of the right hemispheric brain parenchyma. This is accompanied with dilatation of the right lateral ventricle and prominence of the cerebral sulci. The DTI (diffusion tensor imaging) fiber tractography image reveals an abrupt cut-off of the white matter fibers at the margin of the nectrotic brain parenchyma. Interestingly the posprocessing of the fMRI images show activated left cortical areas with left lower extremity motor task which may be related to brain plasticity.

Post-surgical:

T2-weighted TSE coronal DTI fiber tractography
T2-weighted TSE coronal
DTI fiber tractography
Postprocessed fMRI of left lower extremity motor task
Postprocessed fMRI of left lower extremity motor task

 

The post-surgical T2-weighted TSE coronal image reveals a partial right cerebral hemispherectomy while the DTI fiber tractography image demonstrates the remaining white matter fibers after surgery. The postprocessed fMRI images, compared with those of the pre-surgical examination, once again demonstrates the same activated areas in the left cerebral cortex with left lower extremity motor task.

Working diagnosis:

Necrosis and atrophy of the right hemispheric brain parenchyma.

Impact of system imaging:

The Achieva 3.0T system offers MR Spectroscopy, BOLD fMRI, DTI, perfusion-weighted images as well as conventional sequences providing a complete and sophisticated neuro package.

 

The Ambient experience offers soothing, thematic audio-visual surroundings in the examination room which may help to reduce patient anxiety and stress. This increases patient co-operation which in turn helps to produce optimal examination results as well as keeping the examination time as short as possible.

 

 

For background information, see:



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Case Study
Achieva 3.0T
Release 1
Quasar Dual
Brain, Neuro
 

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