J Korean Med Sci.  2003 Aug;18(4):621-624. 10.3346/jkms.2003.18.4.621.

Multifocal Inflammatory Leukoencephalopathy: Use of Thallium-201 SPECT and Proton MRS

• Hwang YH
• Suh CK
• Park SP

• KMID: 648923
• DOI: http://doi.org/10.3346/jkms.2003.18.4.621

Abstract

In a patient receiving 5-fluorouracil and levamisole, neurologic deficits suggest the cerebral demyelinating syndrome as a differential diagnosis. The authors report a patient diagnosed as multifocal inflammatory leukoencephalopathy for which thallium-201 ((201)Tl) single photon emission computed tomography (SPECT) and proton magnetic resonance spectroscopy (MRS) were employed as noninvasive diagnostic tools. (201)Tl SPECT study was negative and proton MRS showed an increase of choline and lactate and well preserved N-acetylaspartate. These findings support histopathologic findings of multifocal inflammatory leukoencephalopathy revealing demyelination with relative axonal sparing in the patient.

Keyword

Leukoencephalopathy; Fluorouracil; Levamisole; Magnetic Resonance Spectroscopy; Tomography; Emission Computed; Singl-Photon

MeSH Terms

Adjuvants, Immunologic/adverse effects/therapeutic use
Antimetabolites, Antineoplastic/adverse effects/therapeutic use
Aspartic Acid/*analogs & derivatives/metabolism
Axons/pathology
Biopsy
Brain/pathology
Brain Neoplasms/secondary
Choline/metabolism
Colorectal Neoplasms/drug therapy/pathology
Diagnosis, Differential
Fluorouracil/adverse effects/therapeutic use
Human
Lactic Acid/metabolism
Leukoencephalopathy, Progressive Multifocal/*diagnosis/etiology
Levamisole/adverse effects/therapeutic use
Magnetic Resonance Spectroscopy/*methods
Male
Middle Aged
Neoplasm Metastasis
Thallium Radioisotopes/*diagnostic use
Tomography, Emission-Computed, Single-Photon/*methods