68 year old female with progressive speech and cognitive impairment for 2 months was referred for FDG PET /MRI.
PET/MRI revealed Ribbon like areas of altered intensity with restricted diffusion on axial high b-value diffusion images (A, B, C, D) and decreased FDG uptake on fused PET MR images (E, F, G, H) in left fronto-parieto temporal region and right frontal and posterior temporal regions with no abnormal enhancement and consistent with Crutzfeld- Jacob disease. Compared to the MRI done at two previous instances there was serial progression in the extent of involvement.
The parametric map of the relative FDG uptake compared to a standard age-matched database shows marked hypoperfusion in the left cerebral hemisphere (blue areas) (lower panel).
A 48 year old female with cognition impairment and suspected CJD underwent FDG PET/MRI.
PET/MRI revealed similar cortical ribbon sign on DWI (A) appearing dark on ADC(B) and decreased FDG uptake on PET/MR fused (C) and PET (D) images in the left cerebral hemisphere, in addition, to signal changes in bilateral basal ganglia and thalami also a feature of CJD.
Parametric map of the relative FDG uptake compared to a standard age-matched database shows marked hypoperfusion in the left cerebral hemisphere (blue areas), Infective Encephalitis shows increased FDG uptake compared CJ disease which shows decreased FDG uptake and so along with the MR imaging features can be easily differentiated.
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
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The Simultaneous PET-MRI Scan is currently offered at PET-Suite at Apollo Hospital, Sarita Vihar.