Acute disseminated encephalomyelitis: MR Diffusion weighted imaging: Potential diagnostic value and outcome predilection

Acute disseminated encephalomyelitis (ADEM) is an inflammatory disease affecting the central nervous system (CNS) with multiple and variable neurological signs. To assess the diagnostic value of MR Diffusion in diagnosis of ADEM and its outcome predilection. A prospective study included 35 patients conducted for accurate history taking and meticulous clinical examination, radiological imaging including CT in 23 cases, contrast enhanced MRI and MR Diffusion for all cases. Further CSF laboratory investigations were done for all cases. All patients were followed up after I month from the first presentation, after 6months, 12months and after 18months with repeated MRI examination. Thirty-five patients were included in our study over a period of 3years; 9 patients with no abnormality in diffusion WI, 10 patients with T2 shine through effect and 16 patients with restricted diffusion. On follow up, patients with no abnormal diffusion or T2 shine through effect respond to medication and shows complete recovery within 6months. While the other 16 patients with initial restricted diffusion, 7 of them showed recovery within 6months and other 9 patients showed other attacks and complete recovery on long run follow up till 18months. MR Diffusion provides a great help in detection of the brain tissue changes in ADEM in addition to the predilection of the course and outcome of the disease.