MR findings in Acute Disseminated Encephalomyelitis in Children

Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, SNUMRC, Clinical Research Institute, Seoul National University Hospital Department of Radiology, CHA Hospital, Pochon CHA University College of Medicine Received February 4, 2006 ; Accepted July 31, 2006 Address reprint requests to : In-One Kim, M.D., Department of Radiology, Seoul National University Children’s Hospital 28, Yongon-dong, Chongno-gu, Seoul 110-744, Korea Tel. 82-2-2072-3608 Fax. 82-2-747-5781 Purpose: We reviewed the distribution of lesion and the characteristics of the MR findings of acute disseminated encephalomyelitis (ADEM) in children. We evaluated the differences in the imaging findings and the clinical outcomes between the patients with deep gray matter involvement and the patients without deep gray matter involvement. Materials and Methods: We retrospectively reviewed the 62 MR examinations of 21 patients who were discharged with the clinical diagnosis of ADEM. The patients were aged from 13 months to 12 years old (mean age: 4.5 years). Follow-up MR examinations were done one to 5 times (mean: 3 times) for 2 weeks to 4 years (mean: 3 months) after the initial examination. We compared the signal intensity on T2WI, the enhancement and residue on the MR images and the clinical outcomes between the patients with deep gray matter involvement and the patients without deep gray matter involvement. Results: A total of 21 patients had white matter abnormalities on their initial MR. Fifteen patients (71%) had foci of increased signal intensity on T2WI in the deep gray matter: thalamus (n=15), globus pallidus (n=14) and putamen (n=10). On the followup images, all patients showed decreased signal intensity and enhancement of their lesion. We could not find the significant differences in signal intensity, enhancement and residue on the MRIs and also the clinical outcomes between the patients with deep gray matter involvement and the patients without deep gray matter involvement (<.05). Conclusion: There were no significant differences in the characteristics of the imaging and the clinical outcomes between the ADEM patients with deep gray matter involvement and those ADEM patients without deep gray matter involvement.