Can diffusion tensor imaging (DTI) outperform standard magnetic resonance imaging (MRI) investigations in post-COVID-19 autoimmune encephalitis?
Latini, Francesco ; Fahlström, Markus ; Fällmar, David ; Marklund, Niklas LU
; Cunningham, Janet L.
and Feresiadou, Amalia
(2022)
In Upsala Journal of Medical Sciences
127.
- Abstract
Background: Neurological and psychiatric manifestations related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are widely recognised. Standard magnetic resonance imaging (MRI) investigations are normal in 40–80% of symptomatic patients, eventually delaying appropriate treatment when MRI is unrevealing any structural changes. The aim of this study is to investigate white matter abnormalities during an early stage of post-COVID-19 (coronavirus disease 2019) encephalitis while conventional MRI was normal. Methods: A patient with post-COVID-19 autoimmune encephalitis was investigated by serial MRIs and diffusion tensor imaging (DTI). Ten healthy control individuals (HC) were utilised as a control group for the DTI... (More)
Background: Neurological and psychiatric manifestations related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are widely recognised. Standard magnetic resonance imaging (MRI) investigations are normal in 40–80% of symptomatic patients, eventually delaying appropriate treatment when MRI is unrevealing any structural changes. The aim of this study is to investigate white matter abnormalities during an early stage of post-COVID-19 (coronavirus disease 2019) encephalitis while conventional MRI was normal. Methods: A patient with post-COVID-19 autoimmune encephalitis was investigated by serial MRIs and diffusion tensor imaging (DTI). Ten healthy control individuals (HC) were utilised as a control group for the DTI analysis. Major projection, commissural and association white matter pathways were reconstructed, and multiple diffusion parameters were analysed and then compared to the HC average using a z-test for serial examinations. Results: Eleven days after the onset of neurological symptoms, DTI revealed early white matter changes, compared with HC, when standard MRI was normal. On day 68, DTI showed multiple white matter lesions compared with HC, visible at this time also by the MRI images, indicating inflammatory changes in different association and projection white matter pathways. Conclusion: We confirm a limitation in the sensitivity of conventional MRI at the acute setting of postCOVID-19 autoimmune encephalitis. A complementary DTI investigation could be a valuable diagnostic tool in early therapeutic decisions concerning COVID-19-related neurological symptoms.
(Less)
- author
- Latini, Francesco
; Fahlström, Markus
; Fällmar, David
; Marklund, Niklas
LU
; Cunningham, Janet L.
and Feresiadou, Amalia
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- COVID-19, DTI, encephalitis, MRI, white matter
- in
- Upsala Journal of Medical Sciences
- volume
- 127
- article number
- 8562
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:35722186
- scopus:85130704972
- ISSN
- 0300-9734
- DOI
- 10.48101/ujms.v127.8562
- language
- English
- LU publication?
- yes
- id
- c7976144-66a1-4f55-8792-65da390a6b4f
- date added to LUP
- 2022-12-08 11:43:10
- date last changed
- 2024-04-17 11:54:16
@article{c7976144-66a1-4f55-8792-65da390a6b4f,
abstract = {{<p>Background: Neurological and psychiatric manifestations related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are widely recognised. Standard magnetic resonance imaging (MRI) investigations are normal in 40–80% of symptomatic patients, eventually delaying appropriate treatment when MRI is unrevealing any structural changes. The aim of this study is to investigate white matter abnormalities during an early stage of post-COVID-19 (coronavirus disease 2019) encephalitis while conventional MRI was normal. Methods: A patient with post-COVID-19 autoimmune encephalitis was investigated by serial MRIs and diffusion tensor imaging (DTI). Ten healthy control individuals (HC) were utilised as a control group for the DTI analysis. Major projection, commissural and association white matter pathways were reconstructed, and multiple diffusion parameters were analysed and then compared to the HC average using a z-test for serial examinations. Results: Eleven days after the onset of neurological symptoms, DTI revealed early white matter changes, compared with HC, when standard MRI was normal. On day 68, DTI showed multiple white matter lesions compared with HC, visible at this time also by the MRI images, indicating inflammatory changes in different association and projection white matter pathways. Conclusion: We confirm a limitation in the sensitivity of conventional MRI at the acute setting of postCOVID-19 autoimmune encephalitis. A complementary DTI investigation could be a valuable diagnostic tool in early therapeutic decisions concerning COVID-19-related neurological symptoms.</p>}},
author = {{Latini, Francesco and Fahlström, Markus and Fällmar, David and Marklund, Niklas and Cunningham, Janet L. and Feresiadou, Amalia}},
issn = {{0300-9734}},
keywords = {{COVID-19; DTI; encephalitis; MRI; white matter}},
language = {{eng}},
publisher = {{Taylor & Francis}},
series = {{Upsala Journal of Medical Sciences}},
title = {{Can diffusion tensor imaging (DTI) outperform standard magnetic resonance imaging (MRI) investigations in post-COVID-19 autoimmune encephalitis?}},
url = {{http://dx.doi.org/10.48101/ujms.v127.8562}},
doi = {{10.48101/ujms.v127.8562}},
volume = {{127}},
year = {{2022}},
}