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Research ArticleHead and Neck

MR Imaging of Optic Neuropathy with Extended Echo-Train Acquisition Fluid-Attenuated Inversion Recovery

A.H. Aiken, P. Mukherjee, A.J. Green and C.M. Glastonbury
American Journal of Neuroradiology February 2011, 32 (2) 301-305; DOI: https://doi.org/10.3174/ajnr.A2391
A.H. Aiken
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P. Mukherjee
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A.J. Green
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C.M. Glastonbury
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    Fig 1.

    Graph shows signal-intensity abnormality in all patients on XETA on the correct side of the vision loss, but in only 11/15 on T2-weighted imaging. All 9 patients who presented acutely showed enhancement, but the 6 patients who underwent MR imaging after 4 weeks did not have enhancement. Two patients with negative T2 presented in the chronic period. These patients had no enhancement, so they would have been missed on all of our standard orbital sequences without XETA.

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    Fig 2.

    This graph shows the difference in the degree of signal-intensity abnormality. XETA shows grade 2 (obvious T2 hyperintensity) in most patients, whereas the coronal T2 FSE imaging shows only grade 1 (subtle T2 hyperintensity) in most patients and grade 0 (no signal intensity abnormality) in 4 patients.

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    Fig 3.

    A 30-year-old woman presented with acute left optic neuritis. She had a history of contralateral (right) optic neuritis with persistent decreased visual acuity and an ultimate diagnosis of chronic relapsing inflammatory optic neuropathy. A and B, Coronal (A) and axial (B) XETA reformations show obvious swelling and T2 hyperintensity in the left optic nerve (arrow). Of note, this is 1 of the 2 cases with bilateral abnormality. The right optic nerve is atrophic and also hyperintense secondary to chronic optic neuritis. C, The surrounding perineural CSF makes it difficult to perceive the T2 signal-intensity abnormality within the left optic nerve on this standard coronal T2 FSE FS image (arrow). D, Axial T1-weighted postgadolinium image shows enhancement of the left optic nerve (arrow).

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    Fig 4.

    A 39-year-old man with subacute left optic neuritis but persistent decreased visual acuity. This was a clinically isolated syndrome, which carries a risk for the subsequent diagnosis of MS. A, Mildly motion-degraded coronal T2 FSE images do not show any signal-intensity abnormality within the optic nerves (arrows). B, Coronal XETA image easily shows hyperintensity within the intracanalicular portion of the left optic nerve as compared to the right optic nerve (arrows).

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    Fig 5.

    A 51-year-old man with a history of recurrent unilateral optic neuritis with chorioretinal atrophy on the right. A, Coronal XETA reformation nicely shows T2 hyperintensity in the right optic chiasm (arrow) in this unusual case of isolated intracranial segment disease. B, Coronal T2 FSE does not show the signal-intensity abnormality (arrow), likely because the surrounding CSF T2 hyperintensity obscures it.

Tables

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    SequenceGrade 0Grade 1Grade 2
    R1R2R1R2R1R2
    XETA00451110
    T2 FS537834
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American Journal of Neuroradiology: 32 (2)
American Journal of Neuroradiology
Vol. 32, Issue 2
1 Feb 2011
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Cite this article
A.H. Aiken, P. Mukherjee, A.J. Green, C.M. Glastonbury
MR Imaging of Optic Neuropathy with Extended Echo-Train Acquisition Fluid-Attenuated Inversion Recovery
American Journal of Neuroradiology Feb 2011, 32 (2) 301-305; DOI: 10.3174/ajnr.A2391

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MR Imaging of Optic Neuropathy with Extended Echo-Train Acquisition Fluid-Attenuated Inversion Recovery
A.H. Aiken, P. Mukherjee, A.J. Green, C.M. Glastonbury
American Journal of Neuroradiology Feb 2011, 32 (2) 301-305; DOI: 10.3174/ajnr.A2391
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