Article Figures & Data
Figures
- Fig 1.
Corpus callosum size similar to normal in a patient with HSP-TCC. The patient had mild cognitive impairment and a mild spastic paraparesis. She had SPG 11 pathogenetic mutations. The ear of the lynx sign in this patient is shown in Fig 2.
- Fig 2.
Ears of the lynx on MR imaging. Axial images across the anterior forceps of the corpus callosum. Note an abnormality in the region of the forceps minor of the corpus callosum, corresponding to the genu fibers, which appear dark on T1-weighted and bright on FLAIR images (arrows). Midline sagittal images from the same individuals are seen in Fig 1.
- Fig 3.
Ears of the lynx. Shown are the gray-scale and corresponding negative images of the head of a lynx. The hair tufts at the tip of the ears resemble the MR imaging finding described here. Modified with permission from an original photo taken by Aleksandar Vasic.
- Fig 4.
ROCs for T1-weighted and FLAIR images. The receiver operating characteristic curves show better discrimination for FLAIR than for T1-weighted images. For FLAIR images, the area under the ROC curve showed that the ears of the lynx sign performed in the very good-to-excellent range for a diagnostic test.
Tables
Diagnosis SPG11 (n = 31) or SPG15 (n = 3) Mutations MS Healthy Control Number 34 34 34 Sex, female/male 16:18 16:18 16:18 Mean age (SD) at MRI (yr) 24.6 (7.8) 25.0 (6.8) 24.6 (7.5) Cohen κ for FLAIR (95% CI) Cohen κ for T1-Weighted (95% CI) Rater 1 vs 2 0.74 (0.60–0.88) 0.51 (0.32–0.71) Rater 2 vs 3 0.74 (0.60–0.88) 0.42 (0.24–0.63) Rater 3 vs 4 0.77 (0.63–0.91) 0.75 (0.54–0.96) Rater 1 vs 3 0.66 (0.51–0.82) 0.59 (0.38–0.80) Rater 2 vs 4 0.71 (0.56–0.86) 0.40 (0.20–0.60) Rater 1 vs 4 0.73 (0.59–0.87) 0.62 (0.42–0.83) All raters 0.72 (0.61–0.82) 0.53 (0.35–0.69) ROC Results AUC (95% CI) Sensitivity (95% CI) Specificity (95% CI) Sensitivity and specificity for FLAIR images Rater 1 93.9 (89.4–98.5) 97.0 (84.2–99.9) 90.9 (81.3–96.6) Rater 2 87.1 (79.7–94.5) 81.8 (64.5–93.0) 92.4 (83.2–97.5) Rater 3 87.1 (79.6–94.6) 78.8 (61.1–91.0) 95.5 (87.3–99.1) Rater 4 89.4 (82.3–96.5) 78.8 (61.1–91.0) 100 (94.6–100) Sensitivity and specificity for T1-weighted images Rater 1 84.8 (76.1–93.5) 71.4 (51.3–86.8) 98.2 (90.4–100) Rater 2 81.3 (72.0–90.5) 75.0 (55.1–89.3) 87.5 (75.9–94.8) Rater 3 68.8 (59.4–78.1) 39.3 (21.5–59.4) 98.2 (90.4–100) Rater 4 69.6 (60.4–78.9) 39.3 (21.5–59.4) 100 (93.6–100)
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