Citation, DOI, disclosures and article data
Citation:
Baba Y, Sharma R, Thibodeau R, et al. Cerebral cortical restricted diffusion. Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-86418
Cerebral cortical restricted diffusion, also known as gyriform restricted diffusion, cortical ribboning or cortical ribbon sign, refers to curvilinear hyperintense signal involving the cerebral cortex on DWI images with a corresponding low signal on ADC images.
Causes include the following disorders:
Vascular thrombo-occlusive disease (most common)
Hemodynamic changes
Infections
Metabolic
Others
An acronym has been proposed to cover most of these disorders, which is "CRUMPLED" (Creutzfeldt-Jakob, Reversible cerebral vasoconstriction syndrome, Urea cycle disorders, Mitochondrial, Posterior reversible encephalopathy, Prolonged seizures, Laminar necrosis/hypoxic-ischemic encephalopathy, Liver Disease, Encephalitis, and Diabetes) 5.
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1. Pai V, Pai SY, Pai PB, Pai. Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions. (2020) Insights into imaging. doi:10.1186/s13244-019-0829-0 - Pubmed
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2. Sheerin F, Pretorius PM, Briley D, Meagher T. Differential diagnosis of restricted diffusion confined to the cerebral cortex. (2008) Clinical radiology. 63 (11): 1245-53. doi:10.1016/j.crad.2007.12.018 - Pubmed
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3. Suzuki T, Kidokoro H, Kubota T, Fukasawa T, Suzui R, Tsuji T, Kato T, Yamamoto H, Ohno A, Nakata T, Saitoh S, Okumura A, Natsume J. Transient cortical diffusion restriction in children immediately after prolonged febrile seizures. (2020) European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. 27: 30-36. doi:10.1016/j.ejpn.2020.05.004 - Pubmed
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4. Onder H. Bilateral posterior cortical diffusion restriction due to electrocution. (2016) Clinical neurology and neurosurgery. 151: 143. doi:10.1016/j.clineuro.2016.10.005 - Pubmed
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5. Koksel Y, Benson J, Huang H, Gencturk M, McKinney AM. Review of diffuse cortical injury on diffusion-weighted imaging in acutely encephalopathic patients with an acronym: "CRUMPLED". Eur J Radiol Open. 2018 Nov 9;5:194-201. doi: 10.1016/j.ejro.2018.10.004. PMID: 30456218; PMCID: PMC6231053.
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