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Research ArticleAdult Brain

Association of Developmental Venous Anomalies with Demyelinating Lesions in Patients with Multiple Sclerosis

D.M. Rogers, M.E. Peckham, L.M. Shah and R.H. Wiggins
American Journal of Neuroradiology January 2018, 39 (1) 97-101; DOI: https://doi.org/10.3174/ajnr.A5374
D.M. Rogers
aFrom the Department of Radiology and Imaging Science, University of Utah Medical Center, Salt Lake City, Utah.
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M.E. Peckham
aFrom the Department of Radiology and Imaging Science, University of Utah Medical Center, Salt Lake City, Utah.
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L.M. Shah
aFrom the Department of Radiology and Imaging Science, University of Utah Medical Center, Salt Lake City, Utah.
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R.H. Wiggins III
aFrom the Department of Radiology and Imaging Science, University of Utah Medical Center, Salt Lake City, Utah.
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    Fig 1.

    A and B, Axial contrast-enhanced and fat-saturated MR imaging show a right cerebellar DVA (A, arrow) surrounded by patchy parenchymal enhancement (B, arrow). C, Axial FLAIR MR imaging shows corresponding hyperintense lesion in the right cerebellum (arrow). D, Axial susceptibility-weighted imaging maximum intensity projection shows a large right cerebellar DVA (arrow). E, H&E staining 20× shows moderately hypercellular cerebellar white matter with infiltrating macrophages (circled). In addition, immunohistochemical staining demonstrated intact neurofilament and positive CD68 histiocytes, and Luxol fast blue stain showed myelin loss (not pictured).

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    Fig 2.

    A and B, Sagittal contrast-enhanced T1 and FLAIR MR images show a large left frontal lobe DVA (A, arrow) surrounded by a lesion with discontinuous leading-edge enhancement (B, arrow), typical for tumefactive demyelination. C and D, Sagittal FLAIR MR images at the same anatomic location with a 15-month interval show the development of a demyelinating plaque adjacent to the occipital horn of the right lateral ventricle (arrows). E, Coronal T2 with fat-saturation MR imaging shows left optic nerve hyperintensity (arrow). The patient presented with optic neuritis 15 months before imaging in A and B. F, Axial contrast-enhanced T1 with fat saturation MR imaging shows left optic nerve enhancement (arrow) in the setting of optic neuritis.

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    Fig 3.

    A, Sagittal FLAIR MR imaging shows multiple hyperintense callosal and pericallosal multiple sclerosis plaques (Dawson fingers; arrow) B, Axial T2 MR imaging shows a hyperintense left middle cerebellar peduncle lesion (midline arrow) associated with a flow void (central vein sign; left lateral arrow), which extends from the DVA better demonstrated in image C. C and D, Axial contrast-enhanced T1 MR images show an enhancing left middle cerebellar peduncle lesion (midline arrow) closely associated with a left cerebellar DVA (left lateral arrow). This enhancement was resolved on the follow-up scan at the same anatomic level 2 years later (D, arrow).

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    Fig 4.

    A, Sagittal FLAIR MR imaging shows multiple hyperintense callosal and pericallosal multiple sclerosis plaques (consistent with Dawson fingers; arrow). B, Axial contrast-enhanced T1 and C, FLAIR MR images show a FLAIR hyperintense (C, arrow) and enhancing (B, arrow) lesion in the left frontal lobe. D and E, Coronal contrast-enhanced T1 MR images show an enhancing left frontal lobe lesion (D, arrow) closely associated with a DVA. This enhancement was resolved on the follow-up scan 9 months later (E, arrow).

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    Fig 5.

    A, Axial contrast-enhanced T1 MR imaging shows a right parietal lobe DVA (arrow). B and C, Axial FLAIR MR images over an 8-month interval show development of right parietal lobe hyperintense plaques (B and C, arrows) oriented along the course of the DVA demonstrated in A.

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American Journal of Neuroradiology: 39 (1)
American Journal of Neuroradiology
Vol. 39, Issue 1
1 Jan 2018
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D.M. Rogers, M.E. Peckham, L.M. Shah, R.H. Wiggins
Association of Developmental Venous Anomalies with Demyelinating Lesions in Patients with Multiple Sclerosis
American Journal of Neuroradiology Jan 2018, 39 (1) 97-101; DOI: 10.3174/ajnr.A5374

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Association of Developmental Venous Anomalies with Demyelinating Lesions in Patients with Multiple Sclerosis
D.M. Rogers, M.E. Peckham, L.M. Shah, R.H. Wiggins
American Journal of Neuroradiology Jan 2018, 39 (1) 97-101; DOI: 10.3174/ajnr.A5374
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  • Symptomatic Developmental Venous Anomaly: State-of-the-Art Review on Genetics, Pathophysiology, and Imaging Approach to Diagnosis
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