Article Figures & Data
Figures
- Fig 1.
Time course of intralesional ADC values during the first 90 days in all 10 patients. Note that measurements outside the 90-day range are not shown for better visualization of early time points.
- Fig 2.
Exemplary ADC, contrast-enhanced T1-weighted, DWI, and FLAIR images of the first 4 MRI time points of patient 4 during the first 14 days after new symptom onset. The initially low ADC is associated with only slight T2 hyperintensity. The increasing ADC signal intensity on follow-ups is paralleled by the development of prominent T2 hyperintensity. Contrast enhancement is minimal in the zone of reduced ADC initially and becomes very prominent at time points 3 and 4.
- Fig 3.
Exemplary ADC, DWI, contrast-enhanced T1-weighted, and T2-weighted images of the first 3 examinations of patient 9 in the first 15 days after new onset trigeminal sensory loss. The fascicular trigeminal fibers are affected by an acute lesion (circled in green). The lesion shows hyperintensity on DWI and a reduced ADC, while minimal T2 hyperintensity is noted without contrast enhancement on T1-weighted MRI initially. With time, the ADC pseudonormalizes and increases, while T2 hyperintensity and contrast enhancement become more prominent.
Tables
No. Age (yr)/Sex Disease Duration/Diagnosis New Clinical Symptoms Symptom Onset to MRI (days) Max. ADC ↓ Treatment Acute/Prophylaxis OCB 1 19/F 2 yr/RRMS Right internuclear ophthalmoplegia 1 −41% IV cortisone/interferon + 2 21/F 1 yr/RRMS Dysarthria 0 −66% IV cortisone/– + 3 20/F 1 yr/RRMS Vertigo, left-sided numbness 1.5 −41% IV cortisone/– + 4 45/F 1.5 yr/RRMS Right-sided weakness 2 −20% IV cortisone/– + 5 25/F 1 yr/RRMS Dysarthria, right-sided weakness 4 −17% IV cortisone/– − 6 25/F Initial presentation/CIS Dysarthria, left-sided weakness and numbness 2 −51% IV cortisone/– + 7 30/F 1.5 yr/RRMS Left-sided arm weakness 2 −16% IV cortisone/– + 8 33/F 0.5 yr/RRMS Hemianopia 3 −22% IV cortisone/– + 9 31/M 1 yr/RRMS N.V. numbness 1 −24% IV cortisone/– + 10 44/M 2 yr/RRMS Right-sided weakness 3 −41% IV cortisone/interferon + -
Note:—OCB indicates oligoclonal bands; +, positive OCB; −, negative OCB.
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Patient Day Patient 1 Day 1 Day 8 Day 17 Day 55 ADC −41 10 21 50 T2 17 18 25 43 Patient 2 Day 0 Day 7 Day 14 Day 21 Day 49 Day 83 Day 207 ADC −66 −44 −34 −18 72 37 36 T2 19 20 32 46 64 48 42 Patient 3 Day 1 Day 8 Day 35 Day 42 ADC −41 −7 47 41 T2 15 80 86 35 Patient 4 Day 2 Day 6 Day 10 Day 14 Day 85 Day 175 ADC −20 −15 −11 56 60 125 T2 32 50 54 87 105 43 Patient 5 Day 4 Day 12 Day 20 Day 29 Day 65 ADC −17 5 10 18 30 T2 35 56 72 65 52 Patient 6 Day 2 Day 6 Day 14 Day 28 ADC −51 −35 63 130 T2 37 62 98 74 Patient 7 Day 2 Day 10 Day 21 Day 30 Day 66 Day 106 ADC −16 5 45 50 102 105 T2 23 45 86 73 66 65 Patient 8 Day 3 Day 6 Day 9 Day 21 Day 64 ADC −22 −4 25 55 62 T2 25 45 57 63 66 Patient 9 Day 1 Day 8 Day 15 Day 21 Day 34 ADC −24 12 32 53 59 T2 15 20 18 31 45 Patient 10 Day 3 Day 15 Day 30 Day 37 Day 51 Day 66 ADC −41 −25 12 27 58 62 T2 8 32 46 63 78 54 -
↵a Values are given relative to the NAWM in the contralateral hemisphere.
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