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Multiple sclerosis with acute optic neuritis

Case Study
Savatovsky, Julien, M.D. Fondation Ophtalmologique Adolphe de Rothschild • France

Patient history

A 23-year-old female with a past history of transient left facial paresthesias presented with left visual loss since 3 days. She was referred for an MRI examination at Foundation Rothschild, Paris, France.

MR examination

The examination was performed on Ingenia 3.0T using a 32-channel dS Head coil.

Total scan time (including SmartBrain) was 18:04 minutes.

Images

3D FLAIR with MPR reformats Voxels 0.9 x 0.9 x 0.9 mm, scan time 4:24 min <br>
<br>
3D FLAIR with MPR reformats
Voxels 0.9 x 0.9 x 0.9 mm, scan time 4:24 min

3D FLAIR axial reformat Axial T2W Voxels 0.45 x 0.45 x 3 mm<br>                                                                       Scan time 2:12 min.<br>
<br>
3D FLAIR axial reformat
Axial T2W
Voxels 0.45 x 0.45 x 3 mm
Scan time 2:12 min.

3D SWI EPI, saggital raw image Voxels 0.7 x 0.7 x 0.7 mm<br>
Scan time 2:36 min. <br>
<br>3D CE-T1 TSE, coronal reformat Voxels 0.95 x 0.95 x 0.95 mm <br>
Scan time 3:56 min. <br>
<br>Coronal T2W, high resolution Voxels 0.3 x 0.3 x 2.3 mm<br>
Scan time 4:06 min. <br>
<br>
3D SWI EPI, saggital raw image
3D CE-T1 TSE, coronal reformat
Coronal T2W, high resolution
Voxels 0.7 x 0.7 x 0.7 mm
Scan time 2:36 min.

Voxels 0.95 x 0.95 x 0.95 mm
Scan time 3:56 min.

Voxels 0.3 x 0.3 x 2.3 mm
Scan time 4:06 min.

The 3D FLAIR and MPR reformats show multiple T2 FLAIR high signal intensity lesions, including in paraventricular regions and juxtacortical white matter. The axial 3D FLAIR reformat and axial T2-weighted image show two lesions in the brainstem and one in the right superior cerebellar peduncule.

 

On the 3D SWI EPI image the medullary vein (linear low signal intensity) is seen in the center of a periventricular inflammatory lesion. The coronal high resolution T2-weighted and reformatted 3D CE T1-TSE demonstrate the left optic nerve acute inflammatory lesion in high T2 signal intensity. The diagnosis is multiple sclerosis fulfilling spatial dissemination criteria and acute left optic neuritis.

Clinical impact

The powerful combination of dStream and dS SENSE provides high spatial resolution, SNR and good contrast of lesions on FLAIR images, which allows a good identification of lesions and therefore helps to diagnose MS early in the course of the disease. Such high image quality can be achieved in a short acquisition time, thanks to the possibility to use high dS SENSE factors. Being able to use short sequences allows to invest more time during the same exam session for higher resolution and more specific acquisitions, such as the high-resolution optic nerve imaging in this patient.

Related reading:



Results from case studies are not predictive of results in other cases. Results in other cases may vary.


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Jan 20, 2015

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Case Study
Ingenia 3.0T
32-channel dS Head coil, Brain, dS SENSE, dStream, MS, multiple sclerosis, Neuro
 

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