BACKGROUND: Although the diagnosis of Creutzfeld-Jakob disease (CJD) is straightforward in fully developed cases, a definitive diagnosis can be difficult early in the course of the illness. T2-weighted magnetic resonance imaging (MRI) signal abnormalities, and recently, diffusion-weighted MRI abnormalities, have been described in patients with CJD, suggesting the utility of MRI in the early recognition of CJD. OBJECTIVE: To correlate diffusion-weighted MRI signal abnormalities with neuropathologic changes in CJD. MATERIALS AND METHODS: Diffusion-weighted MRI and neuropathologic changes of 2 patients with autopsy-proven CJD were examined in a blinded fashion by a neuroradiologist and a neuropathologist. RESULTS: Areas of bright signal on diffusion-weighted MRI correlated with a higher degree of spongiform changes. CONCLUSION: Diffusion-weighted MRI in CJD demonstrates specific-signal abnormalities that correlate well with areas of the most severe and characteristic neuropathologic changes.
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Mittal et al. (2002) studied this question.