Findings
- Holocord T2/STIR signal hyperintensity extending from the level of C2-C3 into the upper thoracic spinal cord with areas of signal intensity greater than or equal to that of CSF
- Associated patchy enhancement and mild cord expansion
- Additional areas of patchy T2/STIR signal hyperintensity along the dorsal aspect of the medulla and caudal pons
- No significant focal degenerative changes
- Normal marrow signal and vertebral body alignment
Diagnosis
Anti-MOG
Sample Report
Longitudinally-extensive holocord lesion extending from C2-C3 through the upper thoracic spinal cord with areas of T2/STIR signal intensity greater than or equal to that of CSF. Associated patchy enhancement and mild cord expansion. Additional areas of patchy T2/STIR signal hyperintensity are noted along the dorsal aspect of the medulla and caudal pons. This appearance is most consistent with a demyelinating process (with primary considerations including neuromyelitis optica spectrum disorders and ADEM) or infectious encephalomyelitis. Recommend CSF analysis for further evaluation. Additionally, recommend imaging of the remainder of the neural axis to include brain, thoracic spine, and lumbar spine MRI with and without contrast.
Discussion