Question about MRI scanning

[Ben_Hicks]

Would an MRI scan be able to detect either Creutzfeldt-Jakob disease or New Variant Creutzfeldt-Jakob disease at least six months before symptoms of either started showing in the patient? Both these diseases have long incubation periods and I was wondering if the MRI would be able to pick up any traces of the prions or the incubating disease before the symptoms started to appear.

Thanking you in advance for all your help.

Regards,

Ben.

[alice_in_wonderland]

Not as far as I know - my understanding is that the only way to correctly diagnose either variant is with an autopsy of the brain.

This, I’m gleaning from Canadian Blood Services info.

Al.

(I think prions are pretty teeny - they wouldn’t show up on an MRI).

[alice_in_wonderland]

here is some more info:

Currently, spongiform encephalopathies or prion diseases in humans and animals can only be reliably diagnosed by pathological examination of brain tissue…Some proteins have already been shown to be increased in CSF of CJD cases, such as neuronspecific enolase (NSE), creatine kinase BB (CK-BB) and S-100b.

This site suggests that a test of proteins or enzymes could potentially lead to earlier diagnosis.

[Ben_Hicks]

Thank you for your reply alice_in_wonderland and for taking the time to check up on this issue for me. I appreciate it a great deal.

However, I am aware that the only way to confirm diagnosis is through a brain biopsy. I should have been more specific. The best an MRI scan can do is indicate that one may have CJD by scanning for (I think) abnormal wave patterns. However, is it possible to check for any abnormalities which could suggest CJD or new varient CJD 6 months before ths symptoms appear?

[alice_in_wonderland]

Ok - here’s some more info I found.

According to this:

Bilateral symmetric, high signal intensities on T2-weighted MRIs were present in the basal ganglia of 109 (67%) of 162 patients with CJD.

so it would appear that an MRI can be used to assist in diagnosis; however, it suggests that the patients tested already had suspected cases of CJD, and, therefore, presumably, symptoms.

I would presume that 6 months before the onset of symptoms, theoretically abnormalities may be present in the brain, but that is really just a WAG on my part. Once CJD kicks in (so to speak), I have no idea how quickly abnormalities would progress to the point of being visible on an MRI.

[alice_in_wonderland]

Well heck - I just answered my own question here:

But given the rapid progression of the disease, it would not be unusual for MR and CT images, obtained at early stages of the disease, to appear normal.

There you go - 6 monts prediagnosis, the MRI would be clear (assuming there was no co-morbidity present).

[Ben_Hicks]

Excellent. Thank you very much for your help