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Van der Knaap et al, [ 19 ] in a report concerning the brain MRI of patients with Alexander disease, have identified 5 criteria, 4 of which are remarkable, for the diagnosis of the disease: an extensive cerebral white matter change with frontal predominance; a periventricular rim with high signal on T1-weighted images and low signal on T2-weighted images; abnormalities of basal ganglia and thalami; brain stem abnormalities; and contrast enhancement of particular gray and white matter structures.    
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