“Bright spotty lesions” on spinal magnetic resonance imaging differentiate neuromyelitis optica from multiple sclerosis

2013 ◽  
Vol 20 (3) ◽  
pp. 331-337 ◽  
Author(s):  
Tadahiro Yonezu ◽  
Shoichi Ito ◽  
Masahiro Mori ◽  
Yoshitsugu Ogawa ◽  
Takahiro Makino ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Length Distribution ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Central Gray Matter ◽  
Spinal Magnetic Resonance Imaging ◽  
Spinal Mri

Background: Spinal magnetic resonance imaging (MRI) finding of longitudinally extensive spinal cord lesions (LESCL) extending over three vertebral segments and involvements of spinal central gray matter have been reported in patients with neuromyelitis optica (NMO). Objectives: We aimed to review spinal MRI findings in NMO and multiple sclerosis (MS), and to determine whether the “bright spotty lesions” (BSLs) are a discriminative finding of NMO. Methods: For this study, 24 consecutive patients with NMO and 34 patients with MS were enrolled. BSLs were defined as very hyperintense spotty lesions on axial T2WI. We also studied the length, distribution, signal homogeneity, size, and presence of contrast-enhanced lesions. Results: BSLs were more frequently found in patients with NMO (54%) than in those with MS (3%; p < 0.01). LESCL were found in 67% of the NMO patients. BSLs were seen in 63% of the patients without LESCL. BSLs or LESCL were found in 88% of the NMO patients. Inhomogeneous lesions, transversally extensive lesions, and central lesions were more frequently seen in NMO than in MS. Conclusions: BSLs are a newly defined spinal MRI finding specifically seen in NMO. In combination with LESCL, BSLs can help differentiate patients with NMO from those with MS with higher sensitivity than LESCL alone.

scholarly journals Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging

2015 ◽  
Vol 22 (3) ◽  
pp. 302-311 ◽  
Author(s):  
Yeliz Pekcevik ◽  
Charles H Mitchell ◽  
Maureen A Mealy ◽  
Gunes Orman ◽  
In H Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
Transverse Myelitis ◽  
Resonance Imaging ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Mri Findings ◽  
Spinal Magnetic Resonance Imaging ◽  
Extensive Transverse Myelitis

Background: Although spinal magnetic resonance imaging (MRI) findings of neuromyelitis optica (NMO) have been described, there is limited data available that help differentiate NMO from other causes of longitudinally extensive transverse myelitis (LETM). Objective: To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM. Methods: We enrolled 94 patients with LETM into our study. Bright spotty lesions (BSL), the lesion distribution and location were evaluated on axial T2-weighted images. Brainstem extension, cord expansion, T1 darkness and lesion enhancement were noted. We also reviewed the brain MRI of the patients during LETM. Results: Patients with NMO had a greater amount of BSL and T1 dark lesions ( p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord’s cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO. Conclusions: Certain spinal cord MRI features are more commonly seen in NMO patients and so obtaining brain MRI during LETM may support diagnosis.

Comparison of CSF Cytology and Spinal Magnetic Resonance Imaging in the Detection of Leptomeningeal Disease in Pediatric Medulloblastoma or Primitive Neuroectodermal Tumor

1999 ◽  
Vol 17 (10) ◽  
pp. 3234-3237 ◽  
Author(s):  
Maryam Fouladi ◽  
Amar Gajjar ◽  
James M. Boyett ◽  
Andrew W. Walter ◽  
Stephen J. Thompson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Primitive Neuroectodermal Tumor ◽  
Neuroectodermal Tumor ◽  
Leptomeningeal Disease ◽  
Malignant Cells ◽  
Csf Cytology ◽  
Resonance Imaging ◽  
Spinal Magnetic Resonance Imaging ◽  
Spinal Mri

PURPOSE: Leptomeningeal disease (LMD) significantly affects the prognosis and treatment of pediatric patients with medulloblastoma or primitive neuroectodermal tumor (PNET). Examination of CSF for malignant cells, detection of LMD on spinal magnetic resonance imaging (MRI), or both are the methods routinely used to diagnose LMD. A recent study suggested 100% correlation between CSF and MRI findings in children with medulloblastoma. To determine the validity of this hypothesis, we compared the rate of detection of LMD between concurrent lumbar CSF cytology and spinal MRI performed at diagnosis in patients with medulloblastoma or PNET. PATIENTS AND METHODS: As a part of diagnostic staging, 106 consecutive patients newly diagnosed with medulloblastoma or PNET were evaluated with concurrent lumbar CSF cytology and spinal MRI. CSF cytology was examined for the presence of malignant cells and spinal MRI was reviewed independently for the presence of LMD. RESULTS: Thirty-four patients (32%) were diagnosed with LMD based on CSF cytology, spinal MRI, or both. There were 21 discordant results. Nine patients (8.5%) with positive MRI had negative CSF cytology. Twelve patients (11.3%) with positive CSF cytology had negative MRIs. The exact 95% upper bounds on the proportion of patients with LMD whose disease would have gone undetected using either CSF cytology or MRI as the only diagnostic modality were calculated at 14.4% and 17.7%, respectively. CONCLUSION: With the use of either CSF cytology or spinal MRI alone, LMD would be missed in up to 14% to 18% of patients with medulloblastoma or PNET. Thus, both CSF cytology and spinal MRI should routinely be used to diagnose LMD in patients with medulloblastoma or PNET.

Radiologically isolated syndrome – incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review

2012 ◽  
Vol 19 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Tobias Granberg ◽  
Juha Martola ◽  
Maria Kristoffersen-Wiberg ◽  
Peter Aspelin ◽  
Sten Fredrikson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Disease Modifying Therapy ◽  
Radiologically Isolated Syndrome ◽  
Disease Modifying ◽  
Magnetic Resonance Imaging Mri

With increasing availability of magnetic resonance imaging (MRI), there is also an increase in incidental abnormal findings. MRI findings suggestive of multiple sclerosis in persons without typical multiple sclerosis symptoms and with normal neurological findings are defined as radiologically isolated syndrome (RIS). Half of the persons with RIS have their initial MRI because of headache, and some have a subclinical cognitive impairment similar to that seen in multiple sclerosis. Radiological measurements also show a similarity between RIS and multiple sclerosis. Approximately two-thirds of persons with RIS show radiological progression and one-third develop neurological symptoms during mean follow-up times of up to five years. Cervical cord lesions are important predictors of clinical conversion. Management has to be individualised, but initiation of disease modifying therapy is controversial and not recommended outside of clinical trials since its effects have not been studied in RIS. Future studies should try to establish the prevalence and long-term prognosis of RIS, its impact on quality of life, and define the role of disease modifying therapy in RIS.

Bilateral trigeminal enhancement on magnetic resonance imaging in a patient with multiple sclerosis and trigeminal neuralgia

2007 ◽  
Vol 13 (6) ◽  
pp. 814-816 ◽  
Author(s):  
A. Pichiecchio ◽  
R. Bergamaschi ◽  
E. Tavazzi ◽  
A. Romani ◽  
A. Todeschini ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Root Entry Zone ◽  
Peripheral Nerve Involvement ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

We report on clinical and instrumental findings of a multiple sclerosis (MS) patient with sudden right trigeminal neuralgia (TN). Magnetic resonance imaging (MRI), performed at TN onset, showed enlargement of both trigeminal nerves (TrN) at the root entry zone, with gadolinium enhancement of the cisternal portion. This is the first description of clinical and MRI findings indicative of peripheral involvement of the fifth cranial nerve in a MS patient complaining of TN. Our report shows the concomitant involvement of central and peripheral myelin in MS, and adds further highlights to the question regarding peripheral nerve involvement abnormalities associated with a disease considered limited to the central nervous system (CNS). Multiple Sclerosis 2007; 13: 814-816. http://msj.sagepub.com

Alexia without agraphia in multiple sclerosis: case report with magnetic resonance imaging localization

2004 ◽  
Vol 10 (6) ◽  
pp. 705-707 ◽  
Author(s):  
Yang Mao-Draayer ◽  
Hillel Panitch
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Subsequent Development ◽  
Subcortical White Matter ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Multiple Sclerosis Case ◽  
Hyperintense Lesion ◽  
Magnetic Resonance Imaging Mri

The syndrome of alexia without agraphia occurs rarely in multiple sclerosis (MS). We report a patient with right homonymous hemianopsia and alexia without agraphia as his initial manifestations of relapsing-remitting MS. Magnetic resonance imaging (MRI) demonstrated a hyperintense lesion in the left occipital subcortical white matter (WM) and an enhancing lesion in the splenium of the corpus callosum. The clinical presentation and MRI findings were consistent with disconnection of the functional right occipital visual cortex from structures responsible for language comprehension in the left hemisphere. The diagnosis of MS was confirmed by subsequent development of additional periventricular WM lesions.

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