Serial MRI of sporadic CJD

Head MRI of a 34-year-old patient with pathologically proven sporadic CJD. The initial T2 MRI (A) shows barely perceptible asymmetric hyperintensity in the bilateral caudate and putamen, more prominent on the right. Initial diffusion-weighted MRI (DWI) shows more obvious hyperintensity in the bilateral caudate and putamen, again more prominent on the right (B). DWI also shows slight hyperintensity in the medial frontal lobe cortices (C). MRI 2 weeks later shows more apparent increased signal intensity within the bilateral basal ganglia on T2 (D) and especially FLAIR images (G) with characteristic posterior progression and involvement of the putamen. DWI shows increased signal intensity within the left basal ganglia (E) and medial frontal lobe cortices (F), with new involvement of the posterior right frontal lobe (F). The FLAIR image (H) shows slightly increased signal intensity in the medial frontal lobes and possibly in the posterior right frontal lobe, but the conspicuity of these abnormal regions is better appreciated on the corresponding DWI (F).