Utility of coronal contrast-enhanced fat-suppressed FLAIR in the evaluation of optic neuropathy and atrophy Kevin H. Boegel, Andrew E. Tyan, Veena R.

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Presentation transcript:

Utility of coronal contrast-enhanced fat-suppressed FLAIR in the evaluation of optic neuropathy and atrophy Kevin H. Boegel, Andrew E. Tyan, Veena R. Iyer, Jeffrey B. Rykken, Alexander M. McKinney European Journal of Radiology Open Volume 4, Pages 13-18 (January 2017) DOI: 10.1016/j.ejro.2017.02.002 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 Cohort and control selection criteria. CE-FS-FLAIR=contrast-enhanced fat-suppressed-FLAIR; dis.=disease; ON=optic neuritis. European Journal of Radiology Open 2017 4, 13-18DOI: (10.1016/j.ejro.2017.02.002) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 Control patient. A 41year old male with no history of demyelinating disease, visual symptoms, or WM findings. Coronal CE-FS-FLAIR images (A and B) demonstrate normal signal within both optic nerves (arrows), with adequate CSF and fat suppression. Both nerves were scored “negative” by both neuroradiologists on both reviews. European Journal of Radiology Open 2017 4, 13-18DOI: (10.1016/j.ejro.2017.02.002) Copyright © 2017 The Authors Terms and Conditions

Fig. 3 Optic neuropathy. A 42year old female with a history of acute right optic neuritis 6.5 years earlier. On coronal CE-FS-FLAIR (A and B), both neuroradiologists were blinded to the clinical history, and graded the right optic nerve (dotted arrows) as “definitely positive”, and the left optic nerve (arrows) as negative for optic neuropathy on both reviews. Regarding atrophy, the right was variably graded as “definitely positive”, “equivocal”, and “negative”, based on the reviewer. European Journal of Radiology Open 2017 4, 13-18DOI: (10.1016/j.ejro.2017.02.002) Copyright © 2017 The Authors Terms and Conditions

Fig. 4 Optic neuropathy, atrophy, and interobserver discrepancy. A: In a 29year old male with bilateral optic neuritis 16–20 months prior, both nerves (dotted arrows) are bright on CE-FS-FLAIR, and were scored “definitely positive” for neuropathy and atrophy twice by both observers. B: In a 48year old male with optic neuritis 17.4 years prior, the left nerve was graded “definitely positive” for neuropathy (dotted arrows) twice by one observer, whereas the other graded it “definitely positive”, then “equivocal”. Regarding atrophy, both reviewers variably scored the left nerve on both reviews. European Journal of Radiology Open 2017 4, 13-18DOI: (10.1016/j.ejro.2017.02.002) Copyright © 2017 The Authors Terms and Conditions

Fig. 5 Examples of artifacts. A: In a 56year old female with bilateral optic neuritis 9 months prior, bright signal surrounds both nerves (arrows), perhaps from venous plexi or CSF non-suppression. Both nerves were variably graded “equivocal” or “negative” by both observers for optic neuropathy. B: In another 39year old female with left optic neuritis 15.5 previously, bright signal was noted in adjacent ophthalmic vessels (tiny arrows). Both nerves were variably graded by both observers as “equivocal” and “negative” for optic neuropathy. Regarding atrophy, both nerves were variably scored on both reviewers. European Journal of Radiology Open 2017 4, 13-18DOI: (10.1016/j.ejro.2017.02.002) Copyright © 2017 The Authors Terms and Conditions