case_images: PMC10890804_01
case_images: Representative axial (a) T2-weighted image from an initial MRI study of the brain and orbits showing T2-hyperintense lesions in the intracanalicular portion of the right optic nerve (open arrowheads in a), with contrast enhancement of the right optic nerve after gadolinium administration (arrowheads in b). Both the axial and sagittal (c) images showed also a T2-hyperintense lesion in the right anterior temporal lobe (arrows in a and c). d, e In the repeat MRI study following treatment, there is resolution of inflammatory changes in the right optic nerve as shown by the reduction of T2 signal abnormality (d) and no further contrast enhancement (e).
case_images: crn-2024-0016-0001-536463_F01.jpg
case_images: PMC10890804_01_crn-2024-0016-0001-536463_F01.jpg
case_images: F1
case_images: T2-hyperintense lesions in the right intracanalicular portion of the optic nerve, left internal capsule, along with a T2-hyperintense but T1-hypointense enhancing lesion in the right anterior temporal lobe (Fig. 1a-c). There were also T2-hyperintense lesions in the left centrum semiovale, corpus callosum, superior frontal lobe, and occipital horn of the lateral ventricle. The initial right optic nerve abnormalities improved in subsequent MRI studies (Fig. 1d, e).
case_images: Representative images from initial (a-f) and repeat (g-l) MRI studies of the brain and spinal cord. a-f Images of initial MRI studies including axial T2-weighted (a) and T1 with gadolinium (b) from the brain at the level of the internal capsule; sagittal T2 images of the cervical spinal cord (c) showing the high signal lesion at C3 level (open arrowhead) which was not enhancing in T1 with contrast (d); and thoracic spinal cord T2 (e) and T1 with contrast (f) images showing a non-enhancing lesion at T6-7 level (open arrowhead). g-l In the repeat MRI study 2 years after diagnosis and treatment with IFN-beta-1alpha, axial images of the brain demonstrate new periventricular lesions (arrowheads) in T2 images (g and i) with subtle contrast enhancement (arrows) in corresponding T1 images with contrast (h and j). Furthermore, thoracic spinal cord images (k, l) show enlargement and subtle contrast enhancement of the T6-7 spinal cord lesion (T2 image in k and T1 with contrast in l).
case_images: crn-2024-0016-0001-536463_F02.jpg
case_images: PMC10890804_01_crn-2024-0016-0001-536463_F02.jpg
case_images: F2
case_images: T6/7 spinal cord level that was enhancing, as well as new T2-hyperintense lesions in the genu of the corpus callosum and adjacent to the posterior horn of the right lateral ventricle, with subtle contrast enhancement in some of the new lesions. The rest of the known lesions remained unchanged (Fig. 2).