MRI Findings of Multiple Sclerosis Involving the Brainstem.
10.3348/jkrs.2001.45.5.437
- Author:
Jeong Hoon PARK
1
;
Hae Woong JEONG
;
Hyun Jin KIM
;
Jae Kwoeng CHO
;
Chang Soo KIM
Author Information
1. Department of Diagnostic Radiology, Maryknoll Hospital. hwjeong2000@lycos.co.kr
- Publication Type:Original Article
- Keywords:
Brainstem, MR;
Sclerosis, multiple
- MeSH:
Brain Stem*;
Magnetic Resonance Imaging*;
Medulla Oblongata;
Mesencephalon;
Multiple Sclerosis*;
Pons;
Protons;
Retrospective Studies
- From:Journal of the Korean Radiological Society
2001;45(5):437-444
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To describe MRI findings of multiple sclerosis involving the brainstem. MATERIALS AND METHODS: Among 35 cases of clinically definite multiple sclerosis, the authors retrospectively analysed 20 in which the brainstem was involved. MR images were analysed with regard to involvement sites in the brainstem or other locations, signal intensity, multiplicity, shape, enhancement pattern, and contiguity of brainstem lesions with cisternal or ventricular CSF space. RESULTS: The brainstem was the only site of involvement in five cases (25%), while simultaneous involvement of the brainstem and other sites was observed in 15 cases (75%). No case involved only the midbrain or medulla oblongata, and simultaneous involvement of the midbrain, pons and medulla oblongata was noted in 12 cases (60%). The most frequently involved region of the brainstem was the medulla oblongata (n=18; 90%), followed by the pons (n=17; 85%) and the midbrain (n=16; 80%). Compared with normal white matter, brainstem lesions showed low signal intensity on T1 weighted images, and high signal intensity on T2 weighted, proton density weighted, and FLAIR images. In 17 cases (85%), multiple intensity was observed, and the shape of lesions varied: oval, round, elliptical, patchy, crescentic, confluent or amorphous areas were seen on axial MR images, and in 14 cases (82%), coronal or sagittal scanning showed that lesions were long and tubular. Contiguity between brainstem lesions and cisternal or ventricular CSF space was seen in all cases (100%) involving midbrain (16/16) and medulla oblongata (18/18) and in 15 of 17 (88%) involving the pons. Contrast enhancement was apparent in 7 of 12 cases (58%). CONCLUSION: In the brainstem, MRI demonstrated partial or total contiguity between lesions and cisternal or ventricular CSF space, and coronal or sagittal images showed that lesions were long and tubuler.
