case_images: PMC11420004_01
case_images: The spinal MRI of this patient. (A) The sagittal T2W image of spine shows LETM ranging from C2 to T1 segments (arrow) and SETM in thoracic spinal cord (arrow head). (B,C) Axial T2W images of spine show hyperintensity primarily located in the gray matter and displaying the characteristic "H-sign" in the level of C3 (the upper line in a) and C6 (the lower line in a). (D,E) This hyperintensity displays no enhancement, but the bilateral posterior funiculus was obviously enhanced on axial T1W images (arrow). The bilateral lateral funiculus and right anterior funiculus were also found moderate enhancement (arrow head). (F,G) Axial fluid-attenuated inversion recovery images of brain show multiple lesions located in the right basal ganglia and bilateral cerebral hemispheres, with no enhancement (not shown). (H) A follow-up MRI scan of spine shows obvious absorption of the previously abnormal signals in the spinal cord.
case_images: fped-12-1451688-g001.jpg
case_images: PMC11420004_01_fped-12-1451688-g001.jpg
case_images: F1
case_images: T2-weighted (T2W) sequences. These changes were consistent with a diagnosis of longitudinally extensive transverse myelitis (LETM) and short transverse myelitis (SETM) (Figure 1A), with the C2-T6 segment primarily affected in the gray matter and displaying the characteristic "H-sign" (Figures 1B,C). The white matter exhibited pronounced enhancement following the injection of contrast agent, particularly in the posterior funiculus, depicting primarily patchy enhancement. However, no enhancement was detected in the H-sign (Figures 1D,E). After performing a cranial MRI scan, multiple lesions were observed in the bilateral cerebral hemispheres, right basal ganglia, pons, and medulla, without any enhancement (Figures 1F,G). After 41 days since the initial scan, a follow-up MRI revealed obvious absorption of the previously abnormal signals in the spinal cord without any noticeable enhancement, consistent with the clinical presentation (Figure 1H).