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Encephalomyelitis disseminata
Author:Dr. Dewey, Löbau, Radiologische Praxis Löbau, Germany
Authored date:2004-06-02
Patient History
40 years old female patient.
Control of MS patient under immune therapy.
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MR Imaging Technique
T1W:SE-sagittal, T2W-TGSE axial, Turbo Dark Fluid – coronal and sagittal, MR- Angiography of circle of Willis and cerebral arteries with multiplanar MIPs, CSI with parameter images (NAA, Cholin, Creatin).
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Image Findings
Inconspicuous cranio-cervical transition. There are multiple glial lesions related with encephalomyelitis disseminata in the region of the cervical cord, the medulla oblongata, the midbrain as well as in the region of both hemispheres of cerebellum including both cerebellar peduncles. Clear pontocerebellar cistern. Supratentorially there is a marginally expanded, medially located and symmetrical ventricular system. Periventricularly located expanded glial lesions of white matter. There are also small infiltrates in an in general hypotrophical corpus callosum. No indication of mass effect in the area of cortical or subcortical region of both hemispheres of cerebrum. Large plaque in the supramarginal region and postcentral region on the right side. Expanded outer liquor spaces on fronto-parietal and parietal regions.
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Assessment
Pronounced finding of encephalomyelitis disseminata affecting the cervical cord and medulla oblangata, pons, mesencephalon and large areas of white matter of both hemispheres of the cerebrum. There is already a hypotrophy of corpus callosum and a moderate subcortical atrophy with expanded internal liquor spaces. Large singular plaque in the right supramarginal area. Spectroscopy showed reduced amount of of NAA and cholin periventricularly on the left hand side.
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