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Journal of Pediatric Neurology 2007; 05(03): 233-238
DOI: 10.1055/s-0035-1557390
Case report
Georg Thieme Verlag KG Stuttgart – New York

Diffusion-tensor imaging in stem cell transplantation associated microangiopathy

Hans-Joachim Mentzel
a   Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, Jena, Germany
,
Karim Kentouche
b   Department of Pediatrics, Friedrich-Schiller-University, Jena, Germany
,
Daniel Güllmar
c   Medical Physic Group, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Germany
,
Jürgen R. Reichenbach
c   Medical Physic Group, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Germany
,
Bernd Gruhn
b   Department of Pediatrics, Friedrich-Schiller-University, Jena, Germany
,
Werner A. Kaiser
a   Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, Jena, Germany
› Author Affiliations
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Publication History

18 March 2007

27 March 2007

Publication Date:
30 July 2015 (online)

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Abstract

We describe changes in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in tacrolimus associated encephalopathy. ADC was clearly increased and FA decreased in the involved regions. There was a strong local contrast-enhancing effect along the cortical surface. Repeat magnetic resonance imaging five days later showed an increase in FA; but no contrast enhancement. The observed ADC and FA changes in the acute phase suggest that vasogenic edema may play a pivotal role in tacrolimus induced neurotoxicity. The contrast-effect can be explained by disturbed venous drainage caused by thrombotic microangiopathy.

Keywords

Magnetic resonance imaging - diffusion tensor imaging - fractional anisotropy - apparent diffusion coefficient - tacrolimus - thrombotic thrombocytopenic purpura - stem cell transplantation