Abstract
Marchiafava–Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism. MBD may present with various clinical manifestations. Brain magnetic resonance imaging (MRI) scan is important in prompt diagnosis and treatment of MBD. Here we reported a case of MBD and reviewed literature about the usage of gadolinium-enhanced MRI in MBD. Gadolinium enhancement may indicate a condition at risk of developing necrosis. We therefore recommend a contrast-enhanced MRI study in severe alcoholics with suspected diagnosis of MBD.
Highlights
Marchiafava–Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism, some non-alcoholics have presented with phenotypic and radiological findings that are typical of MBD (Hillbom et al, 2014)
In our case, only part of hyperintensity lesion visualized on diffusionweighted imaging (DWI) appeared to have gadolinium enhancement
The significance of gadolinium enhancement has not been systemically evaluated in MBD
Summary
Marchiafava–Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism, some non-alcoholics have presented with phenotypic and radiological findings that are typical of MBD (Hillbom et al, 2014). Follow-up head MRI was performed 22 days after onset on a 1.5 T magnet (Toshiba, 1.5 T, EXCELART vantage MRT1503 Atla-Basic) with the following parameters: PD-weighted imaging (PDWI): TR/TE of 1550 ms/15 ms; T2WI: TR/TE of 4300 ms/105 ms, slice thickness 5 mm, interslice gap of 1.5 mm; fast fluid attenuated inversion recovery (FLAIR) imaging: TR/TE was 8000 ms/105 ms, field of view was 240 mm, TI was 2200 ms. Corresponded to the clinical improvement, follow-up head MRI performed 22 days after onset showed only mild remaining of the formerly impressively hyperintensity on T2-weighted imaging (Figure 1D). Necrosis without enhancement had occurred in the formerly gadoliniumenhanced lesion (Figures 1D, 2C)
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