Basic and advanced imaging of a case of Balò's concentric sclerosis

(C) Perfusion MRI analysis, based on four regions of interest depicted in D (A, pink, B, white, C, blue, D, red) suggests that the central layers of the ring are more perfused compared to the peripheral ones. n The spectroscopic image (figure 2B) of the lesion documented increased choline peak and d...

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Bibliographic Details
Published in:BMJ case reports Vol. 2013; p. bcr2012008413
Main Authors: Ripellino, Paolo, Stecco, Alessandro, Leone, Maurizio A, Cantello, Roberto
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 25.01.2013
BMJ Publishing Group LTD
BMJ Publishing Group
Series:Images in
Subjects:
51-70 years
Biopsy
Diffuse Cerebral Sclerosis of Schilder - diagnosis
Diffuse Cerebral Sclerosis of Schilder - drug therapy
Diffusion Magnetic Resonance Imaging
Europe (West)
Female
Humans
Images In
Magnetic Resonance Angiography
Middle Aged
Spectrum Analysis
White
ISSN:1757-790X, 1757-790X
Online Access:Get full text
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Summary:(C) Perfusion MRI analysis, based on four regions of interest depicted in D (A, pink, B, white, C, blue, D, red) suggests that the central layers of the ring are more perfused compared to the peripheral ones. n The spectroscopic image (figure 2B) of the lesion documented increased choline peak and decreased N-acetyl aspartate peak, but normal peaks in the normal appearing white matter near the lesion.1 The perfusion analysis (figure 2C), based on four different regions of interest (figure 2D), suggested a decreasing gradient of perfusion from the centre to the periphery of the lesion, supporting the hypothesis that the centre of the ring corresponds anatomically to a deep venous vessel.3 Authors are not aware of previous report of perfusion studies in Balò's sclerosis. n Cerebrospinal fluid analysis detected oligoclonal bands, without anti-aquaporin-4 antibodies. The right paresis fully recovered after 2 weeks and has not relapsed after 11 months. n The 8 months follow-up MRI showed a reduction in the lesion volume and absence of new demyelinating lesions (figure 3A,B). (A) Axial fluid attenuated inversion recovery sequence and (B) sagittal T2-sequence evidence the reduction in the lesion volume compared to figure 1.
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-008413