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Postiktale MR-Veränderungen

Eine seltene und wichtige Differenzialdiagnose

Postictal MR-changes

A rare and important differential diagnosis

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Zusammenfassung

Hintergrund

Postiktale MR-Veränderungen werden im Kontext ihrer Differenzialdiagnosen analysiert.

Patienten und Methoden

Elf Patienten wurden postiktal im MRT untersucht. Ausgewertet wurden die MR-tomographischen Befundmuster und ihre Differenzialdiagnosen.

Ergebnisse

Bei 90% der Patienten fanden sich fokale kortikal betonte Signalsteigerungen in der T2-Wichtung, bei 90% Diffusionseinschränkungen, bei 70% piale Anreicherungen und bei 40% Signalalterationen des Pulvinars/Thalamus. Häufigste Differenzialdiagnosen waren die Enzephalitis und bei entsprechender Tumoranamnese die Meningeosis carcinomatosa.

Schlussfolgerung

Postiktale MR-Veränderungen sind vielgestaltig und nicht immer leicht von Erkrankungen wie insbesondere der Enzephalitis oder der Meningeosis carcinomatosa zu unterscheiden. Dennoch helfen die Kenntnis typischer postiktaler Befallsmuster und der klinische Verlauf, Fehldiagnosen zu vermeiden.

Abstract

Background

Postictal MR findings are analyzed in the context of MR morphological differential diagnoses.

Patients and methods

Postictal MRI was performed in 11 patients. The patterns of MR changes and their differential diagnoses were analyzed.

Results

Focal accentuation of signal increase in the cortex was found on T2-weighted images in 90% of these cases, pial enhancement in 70% and signal changes of the pulvinar/thalamus in 40%. The most common differential diagnoses were encephalitis, and in tumor patients carcinomatous involvement of the meninges.

Conclusion

Postictal MR changes vary widely and are difficult to differentiate from illnesses such as encephalitis and carcinomatosis involving the meninges. Nevertheless, knowledge of the typical pattern of postictal MR findings and the clinical course may help to avoid mistaken diagnoses.

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Hattingen, E., Raab, P., Lanfermann, H. et al. Postiktale MR-Veränderungen. Radiologe 48, 1058–1065 (2008). https://doi.org/10.1007/s00117-007-1605-6

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  • DOI: https://doi.org/10.1007/s00117-007-1605-6

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