So-Young Huh1, Su-Hyun Kim2, Jae-Won Hyun2, In Hye Jeong2, Min Su Park3, Sang-Hyun Lee4, Ho Jin Kim2. 1. Department of Neurology, College of Medicine, Kosin University, Busan, Korea. 2. Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang-si, Korea. 3. Department of Neurology, College of Medicine, Yeungnam University, Gyeongsan, Korea. 4. Department of Radiology, Research Institute and Hospital of National Cancer Center, Goyang-si, Korea.
Abstract
BACKGROUND: Some patients with neuromyelitis optica spectrum disorders (NMOSD) present with spinal cord lesions extending fewer than three vertebral segments (short transverse myelitis, STM), hindering an early diagnosis. OBJECTIVE: We investigated the frequency and imaging characteristics of STM lesions in patients presenting with myelitis as an initial manifestation of NMOSD. METHODS: Patients seen at three referral hospitals in Korea between June 2005 and March 2015 who met the following inclusion criteria were recruited for review: seropositivity for aquaporin-4 antibody, initial presentation with myelitis and spinal cord magnetic resonance imaging (MRI) performed within 1 month of initial myelitis onset. RESULTS: Of the 76 enrolled patients, 65 (85.5%) collectively had 69 longitudinally extensive transverse myelitis lesions, while the remaining 11 (14.5%) had a total of 15 STM lesions. Of the 15 STM lesions, 5 spanned 2.5 vertebral segments, 6 were continuous over two segments, 3 showed a length of 1.5 segments and 1 was confined to a single segment. On axial imaging, all of the STM lesions involved the central grey matter. CONCLUSION: These MRI findings suggested that STM does not preclude the possibility of an NMOSD diagnosis.
BACKGROUND: Some patients with neuromyelitis optica spectrum disorders (NMOSD) present with spinal cord lesions extending fewer than three vertebral segments (short transverse myelitis, STM), hindering an early diagnosis. OBJECTIVE: We investigated the frequency and imaging characteristics of STM lesions in patients presenting with myelitis as an initial manifestation of NMOSD. METHODS:Patients seen at three referral hospitals in Korea between June 2005 and March 2015 who met the following inclusion criteria were recruited for review: seropositivity for aquaporin-4 antibody, initial presentation with myelitis and spinal cord magnetic resonance imaging (MRI) performed within 1 month of initial myelitis onset. RESULTS: Of the 76 enrolled patients, 65 (85.5%) collectively had 69 longitudinally extensive transverse myelitis lesions, while the remaining 11 (14.5%) had a total of 15 STM lesions. Of the 15 STM lesions, 5 spanned 2.5 vertebral segments, 6 were continuous over two segments, 3 showed a length of 1.5 segments and 1 was confined to a single segment. On axial imaging, all of the STM lesions involved the central grey matter. CONCLUSION: These MRI findings suggested that STM does not preclude the possibility of an NMOSD diagnosis.
Authors: Su-Hyun Kim; Maureen A Mealy; Michael Levy; Felix Schmidt; Klemens Ruprecht; Friedemann Paul; Marius Ringelstein; Orhan Aktas; Hans-Peter Hartung; Nasrin Asgari; Jessica Li Tsz-Ching; Sasitorn Siritho; Naraporn Prayoonwiwat; Hyun-June Shin; Jae-Won Hyun; Mira Han; Maria Isabel Leite; Jacqueline Palace; Ho Jin Kim Journal: Neurology Date: 2018-10-26 Impact factor: 9.910