Thrombotic Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura is a multisystem vasculopathy characterized by microangio-pathic hemolytic anemia, thrombocytopenia, renal involvement, fluctuating neurologic manifestations and fever [46]. Neuropathology shows hyaline thrombosis and occlusion of capillaries and arterioles without surrounding inflammatory reaction, which results in infarcts and petechial hemorrhages. MR findings are variable, ranging from punctate white matter lesions to posterior reversible encephalopathy syndrome, multifocal gray matter edema, infarction and hemorrhage. DW imaging can differentiate between these lesions (Fig. 7.20), which is important since some of the lesions seen on T2-weighted images may disappear following treatment with plasma exchange [47].

ic presentation is spontaneous hemorrhage. Gardien-techo T2*-weighted image is sensitive to detect mi-croangiopathy-related microbleeds. DW image and the b0 image can show such micobleeds as low signal intensity spots [48].

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