Apport de l'IRM de diffusion dans le diagnostic de la maladie de Creutzfeldt-Jakob sporadique

Early diagnosis of sporadic Creutzfeldt-Jakob disease (SCJD) is important to plan patient management. The role of diffusion-weighted magnetic resonance imaging (DWI) in SCJD diagnosis is discussed. We report the case of a 62-year-old woman who developed rapidly progressive dementia. Electroencephalography showed diffuse slowing background activity and characteristic periodic triphasic waves suggestive of SCJD. DWI revealed early high signal intensity in the cortex and the basal ganglia early, before appearance of myoclonus and mutism. DWI may be useful for non-invasive early diagnosis of SCJD. We found it show specific abnormalities early and is more sensitive and more specific than EEG and CSF 14-3-3 protein. For some authors, MRI should be included in the diagnostic criteria of SCJD.