Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging
Yeliz Pekcevik, Charles H Mitchell, Maureen A Mealy, Gunes Orman, In H Lee, Scott D Newsome, Carol B Thompson, Carlos A Pardo, Peter A Calabresi, Michael Levy, and Izlem Izbudak
Yeliz Pekcevik, Russell H Morgan, Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins Hospital, Baltimore, MD, USA;
Contributor Information.
Correspondence to: Izlem Izbudak, Division of Neuroradiology, Russell H Morgan, Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 600 N. Wolfe Street, Phipps B-126-B, Baltimore, MD 21287, USA.,
Abstract
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.
Continued at source.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797654/
Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magneti
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