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3D-DIR for early differential diagnostic and prognostic evaluation of NMO

View Article: PubMed Central - PubMed

ABSTRACT

Neuromyelitis optica (NMO) is an acute or subacute lesion of demyelinating disease involving the optic nerve and spinal cord, and imaging techniques and their effects have been the focus of investigations. The aim of the present study was to examine the value of three-dimensional double inversion recovery (3D-DIR) in the early differential diagnostic and prognostic evaluation of NMO. Forty-eight patients with suspicious NMO were included into the study and underwent a combination of serum NMO-IgG quantitative detection and 3D-DIR examination. Forty cases (83.3%) of the suspicious cases were confirmed with NMO. The average time from onset to definite diagnosis was 3.5±0.6 days. The brain showed high T2W and fluid-attenuated inversion recovery (FLAIR) signals, involving 5.8±1.2 sites on average, distributed in the peripheral lateral ventricle, medulla, cerebral white matter, the third ventricle, peripheral aqueduct of sylvius, pons and diencephalon. The average T2W signal strength was 2.73±0.12. The signal intensity of DIR was significantly higher than that of T2W and FLAIR, and the difference was statistically significant. The optic nerve and chiasma showed a high FLAIR signal, with an average signal intensity of 2.13±0.14. The spinal cord showed swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, with an average lesion length of 4.7±0.6 centrum. The relative signal intensity of DIR was significantly higher than that of T2W and FLAIR. Following treatment, the signal intensity of the brain, optic nerve, optic chiasma and spinal cord decreased significantly (P<0.05). In conclusion, 3D-DIR has great application value in the early differential diagnostic and prognostic evaluation of NMO.

No MeSH data available.


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(A) T2WI spinal cord shows swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, and the average length of the lesion was 4.7±0.6 centrum. (B) DIR shows higher signal. Lesions of MS patients were located in the peripheral spinal cord and the average length of the lesion was 0.9±0.2 centrum. DIR, double inversion recovery; MS, multiple sclerosis.
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f4-etm-0-0-3474: (A) T2WI spinal cord shows swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, and the average length of the lesion was 4.7±0.6 centrum. (B) DIR shows higher signal. Lesions of MS patients were located in the peripheral spinal cord and the average length of the lesion was 0.9±0.2 centrum. DIR, double inversion recovery; MS, multiple sclerosis.

Mentions: In the present study, by comparing the imaging characteristics of NMO and MS, we found that: i) the brain of NMO patients showed a low T1W signal, high T2W and FLAIR signals, involving on average 5.8±1.2 sites, distributed in the peripheral lateral ventricle, medulla, cerebral white matter, the third ventricle, peripheral aqueduct of sylvius, pons and diencephalon. AQP4 was similarly highly expressed around the aqueductus Sylvii, ventriculus quartus cerebri and central canal (18). The enhancement of Gd-DTPA was varied, periventricular, pia mater enhancement, corpus callosum linear, and zonal enhancement exhibited specificity (19). The ii) optic nerve and chiasma showed a high FLAIR signal. In the acute period, the spinal cord showed swelling, necrosis and cavity lesions, lesions were enhanced after enhanced scanning, involving primarily gray matters and partial white matters of the central part, transversely, with the average length of the lesion being 4.7±0.6 centrum (Fig. 4), mostly located in neck and thoracic cord, and the lesions of cervical segment can extend up to the lower part of the medulla, and during recovery, the spinal cord in lesion site was able to shrink (19,20). The results of the present study show that the signal intensity of T2W, FLAIR and DIR of NMO patients were significantly higher than those of the MS patients, the average of sites involved were significantly more than those of the MS patients. In addition, after the follow-up of the present study, it was found that the signal intensity of head, optic nerve, optic chiasma and spinal cord following treatment were significantly lower than those prior to treatment.


3D-DIR for early differential diagnostic and prognostic evaluation of NMO
(A) T2WI spinal cord shows swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, and the average length of the lesion was 4.7±0.6 centrum. (B) DIR shows higher signal. Lesions of MS patients were located in the peripheral spinal cord and the average length of the lesion was 0.9±0.2 centrum. DIR, double inversion recovery; MS, multiple sclerosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998000&req=5

f4-etm-0-0-3474: (A) T2WI spinal cord shows swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, and the average length of the lesion was 4.7±0.6 centrum. (B) DIR shows higher signal. Lesions of MS patients were located in the peripheral spinal cord and the average length of the lesion was 0.9±0.2 centrum. DIR, double inversion recovery; MS, multiple sclerosis.
Mentions: In the present study, by comparing the imaging characteristics of NMO and MS, we found that: i) the brain of NMO patients showed a low T1W signal, high T2W and FLAIR signals, involving on average 5.8±1.2 sites, distributed in the peripheral lateral ventricle, medulla, cerebral white matter, the third ventricle, peripheral aqueduct of sylvius, pons and diencephalon. AQP4 was similarly highly expressed around the aqueductus Sylvii, ventriculus quartus cerebri and central canal (18). The enhancement of Gd-DTPA was varied, periventricular, pia mater enhancement, corpus callosum linear, and zonal enhancement exhibited specificity (19). The ii) optic nerve and chiasma showed a high FLAIR signal. In the acute period, the spinal cord showed swelling, necrosis and cavity lesions, lesions were enhanced after enhanced scanning, involving primarily gray matters and partial white matters of the central part, transversely, with the average length of the lesion being 4.7±0.6 centrum (Fig. 4), mostly located in neck and thoracic cord, and the lesions of cervical segment can extend up to the lower part of the medulla, and during recovery, the spinal cord in lesion site was able to shrink (19,20). The results of the present study show that the signal intensity of T2W, FLAIR and DIR of NMO patients were significantly higher than those of the MS patients, the average of sites involved were significantly more than those of the MS patients. In addition, after the follow-up of the present study, it was found that the signal intensity of head, optic nerve, optic chiasma and spinal cord following treatment were significantly lower than those prior to treatment.

View Article: PubMed Central - PubMed

ABSTRACT

Neuromyelitis optica (NMO) is an acute or subacute lesion of demyelinating disease involving the optic nerve and spinal cord, and imaging techniques and their effects have been the focus of investigations. The aim of the present study was to examine the value of three-dimensional double inversion recovery (3D-DIR) in the early differential diagnostic and prognostic evaluation of NMO. Forty-eight patients with suspicious NMO were included into the study and underwent a combination of serum NMO-IgG quantitative detection and 3D-DIR examination. Forty cases (83.3%) of the suspicious cases were confirmed with NMO. The average time from onset to definite diagnosis was 3.5±0.6 days. The brain showed high T2W and fluid-attenuated inversion recovery (FLAIR) signals, involving 5.8±1.2 sites on average, distributed in the peripheral lateral ventricle, medulla, cerebral white matter, the third ventricle, peripheral aqueduct of sylvius, pons and diencephalon. The average T2W signal strength was 2.73±0.12. The signal intensity of DIR was significantly higher than that of T2W and FLAIR, and the difference was statistically significant. The optic nerve and chiasma showed a high FLAIR signal, with an average signal intensity of 2.13±0.14. The spinal cord showed swelling, necrosis and cavity lesion, involving the gray and white matter of the central site, transversely, with an average lesion length of 4.7±0.6 centrum. The relative signal intensity of DIR was significantly higher than that of T2W and FLAIR. Following treatment, the signal intensity of the brain, optic nerve, optic chiasma and spinal cord decreased significantly (P<0.05). In conclusion, 3D-DIR has great application value in the early differential diagnostic and prognostic evaluation of NMO.

No MeSH data available.


Related in: MedlinePlus